Current Patient Forms
Below please find forms available to our current patients. Please use these forms based on your prescribed extreme weight loss protocol.
These forms should be downloaded, completed and faxed to your Last Diet Ever location or brought to your next appointment. Please note that if you email these forms to your counselor, email transmission is not considered secure and should only be used to transmit non-confidential information.
Fax numbers:
Avon - 440-934-3428
Mansfield - 419-529-5677
Medina - 330-721-1456
Sandusky - 419-502-0203
Westerville - 614-392-2849