Many services are available remotely via TELEHEALTH OR phone with the help of fax and e-mail, contact me for more details/pricing.

NUTRITION FOR WEIGHT LOSS

BODY COMPOSITION ASSESSMENT (~15 MIN).   Weight alone is not a clear indicator of good health because it does not distinguish between pounds of body fat and pounds of lean tissue.  Research has shown that carrying too much body fat increases your risk for many serious medical conditions including heart disease, diabetes and even certain forms of cancer.  Additionally, if you are trying to lose weight, it is important to lose fat while maintaining muscle.  One of the most reliable and non-invasive methods of screening body fat is using Bioelectrical Impedance Analysis (BIA).  Our office is equipped with a professional BIA scale to quickly assess your body composition and body fat.  $55.00 Investment/$25 if added to consult**

RESTING METABOLIC RATE – RMR (~45 MIN).  To effectively manage your weight and body composition, it is important to know your daily caloric requirements.  Although there are mathematical formulas to estimate calorie needs, many people are not able to achieve weight loss success based upon these estimates due to the inaccuracy.  We are the only office in the valley to have a “state-of-the-art” Metabolic Cart with research level accuracy.  Accurate assessment of your RMR helps you and your health care team better plan your nutritional needs to maintain energy balance for weight maintenance or negative energy balance for weight loss success.  $135.00 Investment**

COMPLETE METABOLIC EFFICIENCY ASSESSMENT (Includes RMR & Submax Exercise Test ~2 HRS).  Understanding how your body burns calories at rest as well as during activity provides the best tool to prepare an individualized plan for weight loss.  This total metabolic assessment starts with a resting evaluation of energy expenditure followed by a submaximal exercise test to determine your energy utilization related to your heart rate during exercise.  Identifying personal training zones (using HR and/or Power) is key to maximizing your exercise sessions to achieve weight loss.  With our state-of-the-art Metabolic Cart we are able to calculate rates of fat and carbohydrate utilization (grams/minute) as well as calorie expenditure to better understand individualized metabolic efficiency.  A thorough analysis of the results will be performed to provide personalized nutrition recommendations and exercise prescription to maximize your metabolic efficiency and achieve weight loss.  $275.00 Investment**

INDIVIDUALIZED WEIGHT LOSS PROGRAM:

INITIAL VISIT (~ 2 HRS).  Your initial consultation includes the initial assessment, the Complete Metabolic Efficiency Assessment , body composition testing and initiation of an individualized weight loss plan.  $425.00 Investment

MONTHLY FOLLOW-UP/INDIVIDUALIZED WEIGHT LOSS COACHING  (30 MIN each session, 4 included in package pricing + 1 body composition assessment).  Weight loss studies have shown that losing weight can be difficult without regular coaching and follow-up.  This service provides a purely individualized approach to weight loss.  Each visit will include a weekly weigh-in, food record review and counseling using a customized approach to match your unique needs. Body composition testing will also be performed at the end of the month to assure loss of fat and maintenance of lean muscle.  $268.00 Investment

PERFORMANCE EXERCISE TESTING

VO2 MAX ASSESSMENT (~45 MIN).  Your VO2max has 5 main contributing factors including age, gender, genetics, training, weight (as weight goes up, VO2max goes down).  Many of these factors cannot be easily changed; however, working to improve what you can allows you to meet your full potential.  The first step is to obtain an accurate measurement - expect to come and exercise to your maximum (physician clearance may be required).  A set protocol is followed controlling for as many factors as possible.  Once your initial VO2Max is known, serial V02 Max testing can aid in evaluation of the effectiveness of your training program and help you fine tune to achieve your highest aerobic potential.  $145.00 Investment** 

SUBMAX METABOLIC FITNESS ASSESSMENT W/ ANAEROBIC THRESHOLD ANALYSIS (~90 MIN).  This metabolic assessment will determine your aerobic and anaerobic fitness related to your heart rate and power production in a submaximal exercise test.  Identifying personal training zones and your anaerobic threshold (using HR and/or Power) is key to maximizing your exercise sessions while understanding what fuels your body utilizes within these zones can be invaluable for peak sport performance.  With our state-of-the-art Metabolic Cart we are able to calculate rates of fat and carbohydrate utilization (grams/minute) during exercise to determine individualized fueling requirements for maximal metabolic efficiency.  Utilization of fat and carbohydrate during exercise is highly influenced by diet, fitness level and consumption of fuel during exercise.  Thus, a thorough analysis of the results will be performed to provide personalized nutrition recommendations and exercise prescription to enhance your exercise performance, maximize your metabolic efficiency.  $195.00 Investment**

COMPLETE FITNESS EVALUATION (Includes Submax Fitness Assessment, Anaerobic Threshold (AT) and VO2 Max  ~2 HRS).  If you are interested in the most complete fitness evaluation possible, look no further.  Analyzing exercise data for carbohydrate and fat oxidation, heart rate, AT, and VO2 Max allows for an extensive analysis of exercise capacity and a completely personalized nutrition and exercise prescription for optimal athletic performance.  For many years, athletes and coaches have relied on exercise testing to provide crucial information needed to develop individualized training plans, heart rate training zones and improve sport performance.  Repeat testing allows for evaluation of the effectiveness of training programs and can be invaluable in efficiently achieving peak performance without over training.  $355.00 Investment** 

DIABETES  

Diabetes Management Services provided in the office are typically covered by insurance and can be billed directly as Medical Nutrition Therapy (MNT).  For benefit information, you are encouraged to call your insurance provider to check your specific plan coverage and costs (provide them with billing codes 97802/97803).  Unfortunately, phone consultation services are not billable to insurance and are offered as fee-for-service with a 40% cash pay discount.

DIABETES TUNE-UP (60 MIN).  A one-time initial MNT consultation for those seeking personalized diabetes assistance.  You will receive a complete assessment including blood sugar/medication review, diet analysis, exercise evaluation and education tailored to meet your unique health profile.  You will leave with a comprehensive plan focused on meeting your individual goals and national standards for optimal diabetes management.  $177.00 Investment *

FOLLOW-UP COUNSELING (30 / 60 MIN).  Once your diabetes goals are established, you are encouraged to return for follow-up care and support as needed.  $82.00 / $164.00 Investment */**

MONTHLY FOLLOW-UP/INDIVIDUALIZED COACHING (30 or 60 MIN sessions available, 4 included in package pricing).  Whether you are trying to make lifestyle changes to improve your diabetes control, lose weight, or train for an endurance exercise event; it often takes time for education and improvements to be achieved.  In addition, studies have shown that regular coaching and follow-up can improve behavior change adherence and successful outcomes.  This service provides a purely individualized approach and ongoing support to meet your diabetes goals – weekly visits or phone calls.  $268.00/$536.00 Investment (Note: Not billable to insurance)

FINGERSTICK A1C TESTING (~15 MIN).  The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you're managing your diabetes – the result reflects your average blood sugar level for the past 2-3 months. With a simple poke of your finger, the small blood sample is analyzed and you have results in just 5 minutes.  The most recent Clinical Practice Guidelines from the American Diabetes Association recommend that the A1c test be performed at least 2 x year for those who are meeting their diabetes management goals and have stable glucose control, and quarterly for those who are not consistently meeting their diabetes management goals and/or have significant fluctuations in their blood sugar. Your doctor may also recommend quarterly testing if he or she makes changes to your treatment plan.  $30 Investment

*Listed amount is the fee-for-service pricing, payable at the time of service and includes a cash pay discount.  You may try submitting this to your insurance on your own for reimbursement.  Our office can provide direct insurance billing, but you are encouraged to check your Nutrition benefits using CPT Code (97802/97803) prior to your visit.  Direct billing to insurance negates the cash pay discount.

**Multiple/Repeat Service Discount of 10% Available**