Gisela Roux - Registered Dietitian - Glow NutritionLinkedIn 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in your personal details, including your first and last name, date of birth, age, and Medicare number. Ensure accuracy as this information is crucial for your consultation.
  3. Provide your contact information such as address, phone numbers, and email. This will help the clinic reach you for any follow-ups or appointment confirmations.
  4. Complete the medical history section by checking any relevant past medical conditions or surgeries. This helps the dietitian understand your health background.
  5. Fill out the symptoms review section by checking any current issues you may be experiencing. Be honest and thorough to ensure proper evaluation.
  6. If applicable, list any food reactions you've had in the designated section. Include details about symptoms and whether you can still consume those foods.
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Most intolerances cant be diagnosed by blood tests and are usually confirmed by elimination diets with the help of a health professional, like an accredited dietitian.
You may be referred to a food and nutrition specialist (dietitian) if a GP thinks you have a food intolerance.
The Dietitian can be involved in the diagnosis of food intolerances. Food allergies and intolerances are managed by dietary manipulation through the exclusion of the food which is causing the reaction.
If you suspect a food intolerance, a gastroenterologist can help identify and manage the culprit, improving your digestive health and quality of life.
If you or your family have a food allergy, food allergy dietitians can help you to eat well. They can also help you to spot when you have a food allergy or hypersensitivity. Some food allergy dietitians research new ways to find and manage food allergies.

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However, nutritionists usually cannot provide medical nutritional counseling or diagnose or treat illnesses. In contrast, a registered dietitian is a credentialed professional. In addition to doing everything a nutritionist can do, an RD can provide medical nutritional therapy and counseling.