Senin, 05 April 2010
FORMULIR DATA PASIEN
FORMULIR DATA PRIBADI PASIEN
Nama :...................................................................
Alamat ( r ) :...................................................................
............................................................................
( k ) :...................................................................
............................................................................
No.Telp / Fax :...................................................................
Cell phone :...................................................................
Alamat e-mail :...................................................................
Tanggal lahir :...................................................................
Agama :...................................................................
Pekerjaan :...................................................................
Pendidikan :...................................................................
TB / BB :...................................................................
Paket diet yang diambil ( lihat daftar dan harga paket )
........................................................................................................
Lama paket ………………….......…………….....(……) hari
Jenis makanan yang menyebabkan alergi:
1. …………………….….…….......……………..………..
2. …………………….….…….......……………..………..
3. …………………….….…….......……………..………..
Catatan khusus:
1. …………………….….…….......……………..………..
2. …………………….….…….......……………..………..
Dokumen/copy yang diberikan ke Prima Diet Catering :
1. Hasil cek laboratorium.
2. Preskripsi diet dari dokter/dokter ahli gizi/nutrician/therapis............................................
3. Lainnya...................................................................
Data Pemesanan:
1. Tanggal mulai :..........................s/d…....................
2. Tanggal libur :.........................s/d….....................
Ket libur (hari) :……....……………….....................
3. Diantar ke alamat ( r/k/lain2 )*............................. no.telp :.........................., fax :….............................
4. Biaya antar (sesuai keterangan via telp) :
Rp. ………………………..........................................
5. Tanggal dan cara pembayaran :…….....................
Catatan :
*Ahli Madya Gizi ( AMG ) yang bertanggung jawab :
........................................................................................................
No Tlp AMG :......................................................................
LEMBAR PERSETUJUAN
( WAJIB DIBACA OLEH PASIEN / PEMESAN )
1. Akan melakukan pembayaran lunas dimuka melalui transfer bank ke NOREK BCA 6270094455 atas nama PENI HEDI BDN PRIMADIETCATERING atau cash saat catering pertama kali diantar. (Bukti transfer dilampirkan).
2. Pemesanan catering untuk pertama kali paling lambat dilakukan selambat-lambatnya 1 (satu) hari sebelumnya selambatnya jam 15.00 WIB
3. Jika belum melakukan pembayaran pada hari ke 3 (tiga) maka catering selanjutnya tidak dapat kami kirim. Dan bila setelah itu pembayaran telah dilakukan, maka catering akan dikirim kembali
4. Bila akan meneruskan paket catering, mohon efax kan / berikan formulir pemesanan baru ke kurir minimal 2 (dua) hari sebelumnya paket catering berakhir. Atau menginformasikan langsung via telpon.
5. Jika tidak mengembalikan formulir pemesanan atau tidak memberitahukan via telpon, maka kami anggap tidak meneruskan paket catering.
6. Pembatalan pengiriman/pengambilan catering berlaku apabila ada pemberitahuan 1 (satu) hari sebelumnya selambatnya jam 14.00 WIB.
7. Pembatalan pengiriman/pengambilan dengan atau tanpa pemberitahuan pada hari yang sama tidak diperkenankan, dan akan tetap diperhitungkan sebagai pengiriman / pengambilan.
8. Form data pasien wajib dimiliki oleh Prima Diet Catering dan Pasien / Pemesan .
9. Seluruh pasien wajib membaca lembar persetujuan.
10. Dengan menandatangani form data pasien dan lembar persetujuan, maka pasien/pemesan dianggap telah sepakat dan menyetujui seluruh isinya untuk selanjutnya masing–masing pihak dapat melaksanakannya dengan penuh tanggung jawab.
Jakarta, ……………….....................20__
Pemesan/Pasien Prima Diet Catering
(…………………. ) (…………………….. )
THE JAKARTA POST,JANUARY 2010
PRIMA DIET CATERINGShare.. Today at 12:21pm | Edit Note | Delete
Tuesday, January 26, 2010 5:50 PM
Dishes delivered to your door
Sarah Siahaan , Contributor ,
The Jakarta Post | Wed, 08/26/2009 11:48 AM |
Body & Soul Healthy delivery:
Diet and health food delivery services, known locally as diet catering, can deliver nutritionally sound meals to your home or office at certain times, which makes keeping a healthy lifestyle easier.
Diet food delivery services, or diet catering as it is often called in Indonesia, originated as a way to help people whose medical conditions have special dietary requirements, meaning they have to eat or avoid certain foods. Therefore, the original services were set up to serve patients in hospitals.
Ten years ago, Dr Peni Hedi founded Prima Diet Catering, with the main aims being to “serve food for people with specific dietary needs” and to change perceptions about healthy food.
“The perception about hospital food or food for people with certain needs has never been positive,” she says. “Everyone says it has no flavor and doesn’t look edible.”
Having other people prepare our meals for us is a growing trend quite outside special dietary requirements, with a gradual increase in the amount of food eaten away from home. Time pressures from a busy modern lifestyle mean more people are eating out rather than making their own meals.
At the same time, growing health consciousness means a growing concern with eating healthy food.
The trouble is, when you eat something you have not prepared yourself, there’s less guarantee of its nutritional value.
Not, says Peni, that we should cut out red meat altogether.
“Although red meat is assumed to lead to cancer, it actually has a high protein content. However, it also contains a lot of cholesterol. And because the components of red meat are close to humans, we tend to digest it pretty fast.”
The owners of the diet and healthy food delivery services find their customers have numerous reasons for choosing to have their special meals delivered rather than ordering something from the mall.
About half of Prima Diet Catering’s customers choose the service because of medical conditions.
“Fifty percent of our clients have certain dietary restrictions because of illness, 30 percent want to lose weight, and the other 20 percent is for a variety of reasons,” Peni says.
Although meals are more expensive than those from other food delivery and takeaway services, there is good reason for that, Peni explains.
“The concept of our diet catering, especially for the lifestyle diet, is ‘semi-restaurant’, where each client has special and different appetite. We try to fulfill each and every client’s needs,” she says.
“Thus, before they place any orders, they are given a form which includes a list of foods where the clients can name the foods or ingredients that they don’t want or are allergic to.”
Although the package looks expensive, the cost for each meal is approximately Rp 50,000,” she says. “I think that price is fair enough for a healthy meal, because if we eat out at the mall, we sometimes spend more than that and it’s not guaranteed to be healthy.”
For those trying to cultivate or maintain a healthy eating habit, consistency of service is important, which is why most diet caterers strive to deliver the food at the same time every day.
The companies find customers tend to choose diet food delivery services not only because they’re healthy and convenient, but it also removes the need for tedious calorie counting.
And yet, as doctors such as Peni will say, the success of a healthy diet is measured not by looking at the scales but at what is on the table.
“The key for healthy eating habits is not only about having small portions of food but also about the right composition of protein, fat, carbohydrates and vegetables,” she says.
And weight loss, she adds, is about more than just the kilograms. “The focus of weight loss is not about the loss of weight based on the scales, but the loss of body fat.”
Which is why she delivers her clients some advice to go along with their meals.
“I always suggest my clients or patients who want to have a healthy lifestyle or lose some weight that diet alone is never enough,” she says. “The key is to have a balanced food intake and do some exercise.”
HEALTHY FOOD DELIVERY SERVICES
Prima Diet Catering
Jl. Pangkalan Jati V No.53
Jatiwaringin
Phone:
081807878180
0817764899
02144337772
Label: Majalah