I need a referral form — how do I get one? (California and Alabama only)

For health plan insured members located in California and Alabama, a referral is needed before scheduling a telenutrition visit. Follow the link below to download a copy of the Foodsmart Nutrition Network referral form for your primary physician to complete.

Foodsmart Nutrition Network Referral Form 

*If you're paying out of pocket or covered by your employer for a telenutrition visit, a referral is not necessary.