Thank you for your interest in a nutritional appointment with Adriane Angarano, MS, CN. Please take a moment to read through this information as it will clarify what to expect from Adriane, what she does, and what to anticipate at your first and future appointments and communications.
This document contains information for you as a new patient. You should also print and complete the additional forms provided to you in the link. It normally takes about 20-30 minutes to complete the paperwork. Please fill out the forms completely and bring them to the office at your appointment. You may also mail them ahead of the appointment. If you cannot fill them out ahead of time, please let our administrative assistant know, and she will print them out for you to pick up or to complete 30 minutes prior to your appointment. Included in the link are the following documents:
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Health History Intake Form. This is the main health history form where you communicate your goals, history and any other relevant information.
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Metabolic Assessment Form. Although parts may seem repetitive, this is an excellent form to help Adriane prioritize health issues.
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Medical Release Form and Instructions for filling it out to send to your health care provider, usually your doctor. We use this form to request your labs, if you have them, from your doctor/health care provider. Although chart notes are not necessary, if you have an existing health condition, Adriane will be able to more quickly address it if she has your medical history. These are most useful at the 2 nd appointment.
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Patient Registration Form. This is for insurance carriers. If you are coming to see Adriane for an appointment that is covered by insurance, please be sure to fill this out. Bring your insurance card and driver’s license, as HIPAA (the privacy act) requires us to have these on file.
ABOUT ADRIANE
Adriane Angarano is a Certified Nutritionist in the State of Washington. Her focus is on long-term positive transformation through the utilization of client-centered nutritional counseling, education, and awareness to manage her patients’ nutrition care. With the goal of achieving
optimal health through preventing and reversing disease, Adriane employs natural and holistic methods to empower her clients to lead a self-fulfilling healthy lifestyle.
Adriane holds a Master of Science degree in Clinical & Functional Nutrition from New York
Chiropractic College (MS) and a Bachelor of Science degree in Whole Foods Nutrition & Dietetics from Bastyr University (BS). Over the past decade, beyond her formal university education,
Adriane has been immersed in the field of natural health and wellness. She has held various roles as a licensed massage therapist, herb and nutritional supplement educator, student clinician at the
Bastyr Center for Natural Health, and nutritional culinary instructor.
More information is available on the website: www.greenlakenutrition.com.

YOUR FIRST APPOINTMENT
Initial appointments are 50 minutes in length. During the first appointment, Adriane will review the forms attached. She may also conduct some non-invasive clinical tests. These may include observation of your mouth, nails, hair, weight if you did not provide it, blood pressure, oral mineral tests, etc. Some of these tests may be conducted in subsequent appointments and have additional fees which will be discussed.
Once all the information on the forms has been discussed and your goals are clear, Adriane will discuss a plan forward for you regarding the health conditions in which you are interested in treating. There is occasionally time to start nutrition education in the first appointment, but usually it is devoted to complete intake and creating a plan. Over time, we will work on nutrition education and work the plan which will include all or some of the following:
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Recommended lifestyle and eating changes
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Recommended additional blood tests
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Referrals to other practitioners
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A nutritional supplement regimen to help you reach your goals quickly and healthfully
Please bring the following to your first appointment, or mail them to her well in advance:
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All intake forms in link
FOLLOW UP APPOINTMENTS
Your first follow up appointment can be scheduled at the end of your initial session. We also now have online scheduling for follow up appointments. This allows you to schedule when it is most convenient for you at any time day or night. During the time after your initial appointment, note any questions you may have about your new plan. For any urgent questions including negative reactions to your plan, please email us directly as soon as possible at admin@greenlakenutrition.com
. Otherwise, please wait until your scheduled follow up appointment. We recommend keeping a notebook of your treatment and writing down questions as they come up between appointments. For any emergencies, please contact your physician or call
911.
Please bring the following to the second appointment:
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All nutritional supplements you are taking (in a bag)
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Recent blood labs (up to 24 months), if you have them
Follow up appointments usually last 50 minutes. If required, appointments may be longer and will be billed accordingly. This will be discussed on a case-by-case basis.
ADRIANE’S PHILOSOPHY ON NUTRITIONAL SUPPLEMENTS
It is Adriane’s professional opinion that nutritional supplements are meant to supplement a healthy diet; not replace real food. That said, since food manufacturing practices have changed over the years and soils have become depleted, most of us do not get the optimal amount of

nutrients from our diet. As Adriane works with you to achieve optimal health, she may recommend some base-line supplements for general nutrient coverage. In addition, if you are working on a specific health condition, she may recommend other supplements and botanicals to bring your body back into balance more quickly. For most conditions, these additional supplements may be discontinued later, once the imbalance is addressed. Adriane has over a decade of experience working with nutritional and herbal supplements.
PAYMENT
Payment is due at time of service. At this time, Adriane accepts Regence Blue Shield, Aetna,
Premera (including Lifewise), as well as some plans with Cigna, First Choice, Group Health,
Uniform and United Healthcare. Other insurance companies may be coming soon, so be sure to ask our assistant or biller. For cash pay patients, Adriane offers an out-of-pocket discount. If your insurance does not cover any or all of our appointment (such as in the case of unmet deductibles, uncovered services, etc), A&R Billing Services will send you an invoice for the balance. It is your responsibility to pay this upon receipt. Our Fee Schedule is included at the end of this letter. We accept cash, checks, credit and debit cards.
INSURANCE
To see if Adriane’s nutrition services are covered by your insurance company, please call her billing agency, A & R Billing Services, at (206) 725-0683 and ask for Anna.
CANCELLATION POLICY
We request that all appointments you cannot make are cancelled at least 48 business hours in advance of your appointment to avoid a $100 cancellation fee, and more importantly to allow someone else to fill this time slot. With the online system, you can make changes up to 2 days before your appointment. After that, you must call our office to reschedule or cancel at 206-729-
5111.
DIRECTIONS
Please visit our website for a map to our office.
More below: 

Appointments with Nutritionist
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Some appointments may be with culinary expert or associate nutritionist
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All prices are for individuals. Couples are 1.5 times the price, and groups are determined.
-Intake/first appointment
-Follow-up sessions
-Monthly - 1 session/week* (4 total)
-Monthly – 2 sessions/week* (2 total)
$255
$175
(55-70 minutes on average)
(out of pocket discounted rate)
$231/hour
$145/hour
$520 ($130/session)
$270 ($135/session)
-3 Month Package - 1 session/week* (12 total)** $1495
($125/session)
-3 Month Package - bi-monthly* (6 total) ** $750
($125/session)
-6 Month Package - 1 session/week* (24 total)** $2880 ($120/session)
-6 Month Package - bi-monthly* (12 total)** $1440 ($120/session)
$110/hour Appointment with associate nutritionist
(not covered by insurance, upon recommendation)
Menu planning/meal creation $55/hour
(out of pocket discounted rate)
Private cooking class
Monthly group cooking class (max 6/class)
Grocery tour/ pantry overhaul /cooking trio package
$95/hour, $110 for two people
$45/person, $75 for two people
(personalized, private cooking class)
$175 for one person,
$195 for two people (one pantry only)
Private Grocery Store Tour (3 people max) $75/hour
*Monthly packages must be used within 7 weeks, 3 month packages need to be used within 4 months,
6 month packages need to be used within 7 months. Initial appointment cannot be applied to package deals.
**3 and 6 month packages may be paid on a monthly basis (at the beginning of each month). Paying on a monthly basis requires a
$10 additional fee/monthly payment. No outstanding payments allowed beyond the package end-date.
April 1, 2013

Below is a list of blood chemistry lab tests that give a basic overview of nutritional health. If you have had these labs done within the last 24 months, please bring them in. If you have not, you will discuss these and other possible labs during your appointments.
If you and one of the nutritionists decide to get the following tests, you can ask your doctor if he/she will order them. If yes, they may be covered by insurance. We can also order labs at discounted rates. Our cost for the following tests is $150 plus extra for the expanded thyroid panel, which is passed directly on to you. However, blood tests ordered by nutritionists or dietitians are not covered by insurance.
Please make sure you have your blood drawn after a 12-14 hour fast (no food, but water is okay), so it is recommend that you have blood drawn early in the morning and bring breakfast with you.
CBC with differentials including platelets (complete blood count)
TSH
Lipid profile (total cholesterol, HDL, LDL, triglycerides)
Liver profile (ALT/SGPT, albumin, alk phos, AST/SGOT, bilirubin, globulin, LDH, total protein, GGT)
Kidney panel (BUN, serum creatinine, uric acid)
Minerals and bone (iron, calcium, phosphorus)
Fluids and electrolytes (serum chloride, potassium, serum sodium, CO2)
Fasting BG
Vitamin D 25-hydroxy
Blood type
For those with thyroid issues:
Complete Thyroid panel (total T-4/thyroxine, T-3 uptake, free thyroxine index/FTI - T-7, TSH)
Anti-TPO, anti-TGB antibodies