Contact Us! Phone: 404-654-3906 Address: 4045 Orchard Road Suite 520Smyrna, GA 30080 Fax: 404-937-6301 Schedule an Appointment Patient Name * First Name Last Name Patient Age Caregiver Name First Name Last Name Do you plan to use insurance to cover your visit? (Y/N) Choose One Yes No If yes, what insurance do you have? Have you obtained a referral for medical nutrition therapy from your healthcare provider? (Y/N) Choose One Yes No How did you hear about us? Email * Phone (###) ### #### Message * Thank you! We will be in touch soon.