Nourish Labs - RD FAQ
In pilot - Expected launch for all patients and RDs starting October 2025.
General Process
Who actually orders the labs?
When you click ‘Request Lab Panel’ in the portal, your recommendation is routed to our national lab partner. A state-licensed MD or NP reviews the request, signs the requisition, and sends the order to a CLIA-certified laboratory (e.g., Quest, BioReference). You, the RD, never sign the lab order; the entire medical ordering workflow is owned by the clinician network.
In receiving the lab order, the patient does not directly interact with our clinical partner and will have a seamless experience from your lab request to completing their bloodwork. The only occasion where a patient will interface with the ordering clinician is if they have a “Critical” lab value. If a value is above the critical threshold, a clinician calls the patient immediately with medical instructions and documents the outreach.
Who is responsible for the cost of the labs ordered?
Nourish is paying for the full cost of the Basic Panel for patients who meet New Nourish Patient or Follow-up Patient criteria below. There is no out-of-pocket charge for the patient. This is an investment Nourish is making in each patient to ensure they can receive great care at a low cost, and reduces any billing complications stemming from lab ordering.
What specific labs can I request?
At this time, given the importance of collecting patient outcomes, Nourish will offer the following Basic Panel at no cost to eligible patients:
Lipid Panel (Total Cholesterol, LDL-C, HDL-C, Triglycerides)
HbA1c
Basic Metabolic Panel (glucose, electrolytes, kidney markers)
TSH
Looking ahead, we plan to expand our menu of diagnostics to give you and your patients deeper insights over time.
Can I request labs for all my patients or are there restrictions?
New Nourish patient: For baseline testing, we strongly recommend a panel if an adult (18+) has no documented lipid panel and HbA1c drawn within the past 90 days.
This also applies for a patient who has already been seeing an RD at Nourish but who does not have baseline labs completed in the last 90 days.
Follow-up testing: Reference the Clinical Resource Guides and use your judgment. We will include lab request nudges as relevant to patient conditions.
Generally, we recommend at least 12 weeks (~ 3 months) between a patient’s last blood draw and any follow-up panel.
Nourish will monitor lab requests to ensure they meet our standard of care.
Restrictions on eligibility:
Age restrictions: We are currently unable to offer labs for patients under 18 years of age.
Geographic restrictions: We are currently unable to offer lab testing to patients in Rhode Island.
What if I think additional testing is warranted or if my patient requests other lab tests?
At this stage we support only the Basic Panel. If you believe additional labs are clinically valuable - or if the patient requests them - advise the patient to discuss those tests with their PCP, who can order and interpret any additional testing.
If a PCP has been added to the patient’s care team in the Nourish portal, they will receive the updated labs as a part of the next appointment’s chart note summary. Care team will not be automatically sent lab results independently.
Scope of Practice
What is my scope of practice once the lab results return?
RDs may leverage lab results to inform nutrition assessment, education, and behavior change. This includes explaining what the result suggests about diet quality, nutrient status, or lifestyle factors, and you can recommend evidence-based nutrition and behavior changes.
For example, you can relate LDL-C to saturated-fat/soluble-fibre intake, set food/activity goals, and coach adherence.
Do not diagnose medical conditions, prescribe or adjust medications, or chart medical interpretations (e.g., “uncontrolled diabetes”).
Always include the standard recommendation for PCP support. “Please review these results with your primary-care provider (PCP) for medical interpretation and treatment decisions.”
Do I need any special certification or training to request labs?
All RDs will be recommended to complete Nourish’s brief Lab Ordering module (~ 5 minutes) before requesting labs.
Our lab partner is responsible for the official ordering process, so you do not need special certification.
Critical Values & Escalation
What do I do if I see critical or panic values in results?
Our clinician partner monitors every result against Quest/BioReference critical thresholds. If a value crosses that threshold, a clinician phones the patient immediately, provides medical instructions, and documents the call. You will see the critical flag in the chart.
You are not expected to place an emergency call, but you should address the situation and reinforce urgent nutrition guidance at the next session. If the patient does not have a follow-up scheduled, send a personalized nudge to the patient to offer support.
Technical & Workflow
How do I submit a lab request through the system?
Inside any chart note, click Request Lab Panel, confirm eligibility, and select Basic Panel. The system handles routing to the clinician for review, ordering, and signature. You can also request labs through the patient profile.
How long does it take for lab orders to be processed?
Clinician approval: Most requests are signed within hours. Patients will receive an email as soon as its approved and can schedule their appointment from there. Patients going to Quest can book directly in the Nourish app, and patients going to BioReference will be directed to the BioReference website.
Laboratory analysis: Results are typically released within one to three business days after your specimen is collected.
Where can patients get their labs drawn?
Patients can schedule at a Quest site of their choice. We’ll make it easy for them to find a location and book an appointment! For Quest, patient’s can book directly through Nourish.
For NY and NJ patients, they can schedule at a local BioReference site. For BioReference, they’ll be directed to the website for a user-friendly experience.
How and when will I receive the lab results?
Results post simultaneously to the patient’s Lab tab in the Patient Portal, and to your Provider Portal view. You’ll receive an email with the results and these will be added to the patient’s chart note.
Patient Communication
How should I communicate this offering to my patients?
How to frame it (in your own words):
We’re leveling up your care: “We at Nourish have been thinking about how to further personalize your care - to ensure that your plan is curated specifically to your needs.”
Why labs: “In that vein, we’ve added embedded lab testing - the same tests your doctor would order - so we can gather insight into risks beneath the surface that are essential to your health and wellness.”
Benefit: “This helps us personalize your plan, track how your body is responding to our efforts. This will shed more light on where we should focus beyond what we learn from the scale or food logs.”
Ease of sign-up: “It’s just a quick blood draw you can schedule in the app at a nearby center, rather than having to go see your doctor first or pay out of pocket.”
Underscore credibility: “You’ll go to Quest or BioReference (NY and NJ) - the same labs your doctor would use.”
Reassure that there’s no ‘catch’: “As a part of the Nourish program, Nourish covers the full cost, no insurance or payment needed.”
Sample script for a follow-up patient:
“We’ve been thinking about how to make this an even better experience for you and supercharge our work together. As part of that, we’ve added embedded lab testing - the same labs your doctor uses - to reveal risks that can hide beneath the surface and personalize your plan. Since you’ve already been making changes, this is a great way to see how your body is responding.
Nourish now covers a free lab panel at Quest or BioReference - the same labs your doctor uses - so there’s no cost to you. Once you get the labs done, we’ll use the results to fine-tune our approach and care plan. And if anything looks abnormal, we’ll always recommend you follow up with your PCP.”
What does the patient experience look like?
All patients will be able to see the opportunity to schedule their lab appointment from their app home page.
Patients can schedule at a Quest site of their choice. We’ll make it easy for them to find a location and book an appointment all within the Nourish app.
For patients in NY and NJ, they will be directed to a new window to schedule with BioReference.
All patients will be notified of results within the Nourish app and via email.
What communications do patients receive from our partner network?
After you request a panel and the ordering clinician reviews and signs the requisition, the patient will receive an email to schedule the lab draw.
When results are posted to the portal, both the RD and patient will receive an email notifying them of available results.
What do I tell patients about reviewing results with their PCP?
When we show lab results to patients, we will include a reminder to discuss their results with their PCP for formal interpretation. We recommend sharing standard guidance with our patients verbally and in portal messages when reviewing lab results.
Example: “These labs guide our nutrition work, but your PCP is the right provider to interpret these numbers medically and decide on any additional interventions. Please share the results at your next visit.”
Can I share lab results directly with patients?
Results will be available to patients directly through the Nourish portal. There is no action required on your part for them to access the results of their labs.
If a patient can’t locate a report, you can direct them to support@usenourish.com
What if my patient does not have a PCP?
Encourage the patient to establish ongoing medical care, and let them know Nourish can help. Patients should check their insurance plan’s PCP directory and local options. We don’t endorse a PCP partner, but you can offer the below as options for patients to explore (always advise them to confirm in-network coverage and local availability):
One Medical - A large primary-care group with many in-person clinics in major cities plus virtual care; app-based scheduling and convenient follow-ups.
K Health - App-first, virtual primary care with chat/telehealth visits and ongoing care plans.
UpScript / Wheel / SteadyMD - Telehealth platforms that connect patients with licensed clinicians for virtual primary/urgent care; services and state coverage vary. (SteadyMD also operates a consumer-facing virtual care service.)
General Medicine - An emerging virtual primary-care practice focused on convenient online access; availability may still be expanding.
Document any referral needs in the chart.
Documentation
What documentation should I provide around labs?
Requesting labs (when you request the order)
Chart note
Why you’re ordering (e.g., “Baseline cardiometabolic markers missing”)
Patient consent / education - confirmed zero-cost, fasting protocol, no co-pay
Note that requisition form auto-attached & emailed
Appointment Summary (auto-or manual message)
Clear note that labs were ordered and why they matter (“We requested a cardiometabolic lab panel (cholesterol, A1C, kidney and thyroid markers) that will be fully covered by Nourish to personalize your plan”)
Key prep items (fasting, no insurance needed, “already paid” prompt)
Watch for an email from Nourish with instructions on scheduling draw
Reviewing labs (once results are received)
Chart note
Add to chart note action plan / summary: date discussed, note if any critical results already handled by MD
Brief summary of values (normal / abnormal / critical) as defined by Quest or BioReference standards
Nutrition guidance you provided (macro tweaks, lifestyle changes, etc.)
Document patient discussion - concerns, questions, next steps
Referral reminder that the patient should review results with their PCP
Follow-up plan - Update care plan/goals; set follow-up testing timeline if appropriate
Appointment Summary
Lay summary of progress and areas to watch
Patient-friendly explanation of each flagged marker
Next actions (diet goals, schedule follow-up panel, share PDF with PCP)
Attach branded PDF of full lab report - automatically stored in “Documents”
Standard Operating Procedures
What guidance does Nourish provide to support RDs in managing these lab values?
Detailed intervention thresholds for every analyte are documented in Nourish Labs - Standard Operating Procedures page.
Laboratory Reference, Target, and Critical-Threshold Table
Any result that meets a critical threshold is automatically flagged by our partner clinician network, and a clinician will contact the patient directly. These are defined by Quest Diagnostics and BioReference.
Lab test | Standard reference range | Additional condition-specific nuance | Critical threshold* |
|---|---|---|---|
Total Cholesterol | <20 yrs: <170 mg/dL | None | |
LDL-C | <20 yrs: <110 mg/dL | < 70 mg/dL - established ASCVD, type 1 or type 2 diabetes, or 10-year ASCVD risk ≥ 20 % | None |
HDL-C | <20 yrs | None | |
Triglycerides | <20 yrs: <90 mg/dL | None | |
HbA1c | ≤ 5.7% | None | |
TSH | 0.40-4.50 mIU/L | Range varies by individual for patients who are pregnant. | Quest: ≥ 40 mlU/L (<1 yr) |
Fasting Glucose | 65 - 99 mg/dL | Quest: < 40 or ≥ 500 mg/dL | |
Sodium | 135-146 mmol/L | ≤120 or ≥160 mmol/L | |
Chloride | 98-110 mmol/L | BioRef: <70 or >130 mmol/L | |
Calcium | <20 yrs: 8.9-10.4 mg/dL | Quest: ≤6.0 or ≥13.0 mg/dL | |
Potassium | <20 yrs: 3.8-5.1 mmol/L | Quest: ≤2.7 or ≥6.2 mmol/L | |
Urea Nitrogen (BUN) | <20 yrs: 7-20 mg/dL | None | |
Creatinine | 19-29 yrs: | For patients >49 years of age, the upper reference limit for creatinine is approximately 13% higher for people identified as African-American. | Quest & BioRef: ≥ 8.00 mg/dL |
Carbon Dioxide / Bicarbonate | 20-32 mmol/L | None |
Key disclaimers
Official Nourish Statement
Nourish provides nutrition education and counseling. We do not diagnose conditions or prescribe treatment. All laboratory orders are signed by a licensed clinician in our partner network. Critical (“panic”) values are communicated immediately by that clinician. All lab results should also be reviewed with the patient’s primary-care provider (PCP) for formal medical interpretation and follow-up care.
Patient-Facing Copy (checkbox consent)
“Nourish dietitians use these results to provide personalized nutrition support. We do not diagnose or formally interpret labs.
We recommend that you review all results with your PCP. Critical results are communicated immediately by our clinician partner.”
Sample RD Smart-Phrase Footer
“I’m happy to explain how these numbers relate to your nutrition goals. Please review this result with your PCP for medical follow-up.