Be Your Own Boss Starter Kit


Get up and going with your private practice with these done for you office forms. You simply add your logo and contact information and viola! They are ready to use for your business! Read a letter from the creator of these Be Your Own Boss Starter Kit office forms, Faye Berger Mitchell, and see what inspired her to share them with you!

This starter kit consists of the following forms:

  1. Authorization for Release Form
  2. Telephone Intake
  3. Daily Review and Goals with Next Appointment Reminder
  4. Superbill
  5. Checklist for Setting Up an Office
  6. Sample Referral Report
  7. Sample Introductory Letter
  8. Patient Registration Form
  9. Patient Summary Sheet
  10. Payment Policies and Insurance Re-imbursement
  11. Office Policy Information
  12. Nutrition Progress Notes
  13. New Patient Assessment Form
  14. Medical Nutrition Therapy Request Form
  15. Instructions for Completing a Food Diary
  16. Sample Food Journal (1 page to be replicated as needed)
  17. Fax Cover Sheet
  18. Initial Assessment Form (Pediatrics)
  19. Initial Assessment Form (Adults)
  20. Daily Accounting Summary

FayeMitchellThese forms were created by Faye Berger Mitchell, the original private practice guru! A true pioneer, I decided to quit my job and venture out on my own to open a private practice in the Washington, DC metro area. This was a bit risky in 1988, but I built a thriving practice.

Believe it or not, back in the day, the biggest challenge was increasing awareness to physicians and the public that seeing a dietitian outside of a hospital was even a thing. It took some time, but after a few years it became common for docs to refer patients and even for people to seek nutrition services without a referral.

I quickly realized that the more RDNs in private practice, the better our visibility as a profession. Following my passion for mentoring and collegiality, I decided to share my knowledge and expertise with colleagues through workshops, private coaching and consultations, the Be Your Own Boss Starter Kit, and the book I co-authored titled Making Nutrition Your Business – Private Practice and Beyond (AND 2011).

I love to speak to anyone who will listen about becoming an entrepreneur and have been fortunate to present at state and regional dietetic association meetings and speak at FNCE multiple times. Visit me at Foodie On Campus to check out what I have to offer.