Mrs.E, are you going to use the nutritionist at your surgeon's office? If so, they should have a form that will be sufficient. If you're going through your PCP, they're going to need to give fairly detailed information for each visit. The ones mine used included:
My name
Date of visit
Current weight
Approximate times when I ate Breakfast, lunch and dinner
Examples of what I ate at each meal
Exercise - How often, how long, what kinds of exercise
Vitamins/supplements taken
Was I avoiding fats, fried foods and sugar?
Was I complying with the diet plan?
Doctor's signature and date
I switched from my surgeon's nutritionist to my PCP midway through the process and he just used the same forms. I called PCIP today and they have all the paperwork and I will hopefully have an answer by next week. I've seen several people on the board that have gotten approval first time around with PCIP, so I'm keeping my fingers crossed.
Good luck to you!