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NEW PATIENT INATAKE FORM

Looking to start services? Send us an inquiry to start your intake process! Please only send one inquiry. The office will contact you within 48-72 business hours once your information has been processed. All other inquiries please send an email, information is below. *Please note we do receive a high volume of calls and inquiries. Calls are returned within 48 business hours, but a detailed voicemail MUST be left for a call back.

Please note: All information is required as part of our intake process. If insurance has termed or changed we cannot proceed with the intake process. Authorizations and referrals must be valid and match your current active insurance plan.

Any new patients with a history of an eating disorder or current eating disorder will be required to do a phone consultation with the intake manager.

Intake Questions:

Available Days and Times:

Health Plan Name:

Member ID#:

Secondary Health Plan Name:

Member ID#:

Other:

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Main Office Contact:
Ph: (323) 391-7262

Fax: (888) 977-1259

Email: admin@bamboonutrition.com

Administrative Office Hours:

Sunday: CLOSED

Monday: 10:00am to 5:00pm

Tuesday: 9:00am to 5:00pm

Wednesday: 9:00am to 5:00pm

Thursday: 9:00am to 5:00pm

Friday: 9:00am to 5:00pm

Saturday: CLOSED

*Office closed for lunch from 1:00pm to 2:00pm. I

Closed on ALL Federal holidays.

Office Locations:

633 W 5th St.#2607 Los Angeles, CA 90071

1600 Sawtelle Blvd #237 Los Angeles, CA 90025

10200 Sepulveda Blvd Ste 290 Mission Hills, CA 91345

13033 Penn ST #600 Whittier, CA 90602

Feedback:

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Bamboo Nutrition Therapy

Contact Us

NEW PATIENT INATAKE FORM

Intake Questions:

Feedback:

Rate and review your services by visiting https://g.page/r/Ce9xA6YSIF9QEBM/review *All reviews and feedback are appreciated!

Rate and review your services by visiting https://g.page/r/Ce9xA6YSIF9QEBM/review
*All reviews and feedback are appreciated!