Referral
Thank you for entrusting IBS Dietitian to join your patient’s care team.
You will receive a copy of the completed form to your email following submission as confirmation that we received your referral
If you have any questions, please do not hesitate to reach out to use directly at 425-866-6300 or emailing us at info@ibsdietitian.com
Referral form FAQ
Yes. The referral form is encrypted and submitted through a HIPAA-compliant platform.
All fields are optional, but please include:
• Your name and contact information, and
• The patient’s name plus one reliable contact method (phone or email).
You’ll receive a confirmation email once the referral is received. Our team will then contact the patient directly to invite them to schedule a free 15-minute consultation to get started.
If we’re unable to reach the patient within a few days, we’ll follow up by phone and/or email to ensure they have the opportunity to begin care.
Yes. You may send chart notes or relevant records to our admin team and we’ll add them to the patient’s chart for clinician review.
Fax: 812-393-6300
Email: info@ibsdietitian.com
With patient consent, we send you brief updates at key points in care (e.g., initial plan after intake and a discharge summary at program completion). Please provide your preferred contact details so our admin team can deliver these securely.
No. With appropriate consent, our clinicians collaborate with the care team throughout treatment and will coordinate as needed (e.g., clarifying diagnoses, testing, nutrition plans).
If the patient declines consent, we’re unable to share clinical information due to privacy laws. We will still encourage them to keep you informed of their progress.
IBS Patients Toolkit
(for sharing with patient)
Free Patient’s Guide to IBS with symptom tracker
The IBS Patient Toolkit complements your care by providing patients with clear, easy-to-follow educational materials, while helping them apply strategies between appointments.