Question

Counseling Session

Patient/Client ___ _______________________

Date____ ____________________

_____________________________________________________________________________

Nutritional History

Medical History

Age ___53____                      Height __5,6___                    Weight _156____                    BMI 25.2

Labs

Medical Diagnosis

Medications Taking

Nutritional Diagnosis

Etiology (Social, situational, physical, developmental, cultural, psychological, pathological, environmental factors)

`

Signs/Symptoms

Intervention

Goals

Monitoring & Evaluation

24 Hour Diet Recall Form

Please be as specific as possible. Include all beverages, condiments, and portion sizes.

Time	Food Item and Method of Preparation	Amount Eaten	Where

Counsel a family member or a friend. Try to choose someone who really has a nutrition issue – and most of us have some issue – even if it is a preventative issue – such as the person uses too much salt – no hypertension diagnosed, but you’d like to prevent it in the future. But you should explain that this is an assignment, and that that person is really helping you complete your assignment. You are acting like a professional nutritional counselor, as if you were working with someone you don’t actually know.

Use a PES counseling form and fill in as much as you can (but you shouldn’t write out the person’s name). Do a 24-hour recall with the person as part of the counseling session.

Answer 1