Radiation Therapy (RT) is provided in this Cancer Center to approximately 100 outpatients/day, 5 days/week, for 2–7 weeks based on treatment site. With this high patient (pt) load, an effective pt monitoring tool was needed to ensure timely follow up visits by the dietitian (RD). The barriers to follow up visits are RD unavailability or pt unavailability (leave of absence, changed treatment time, prior appointment with nurse, physician, or in simulation). Levels of Care (LOC) classifies pts into one of four levels based on reported side effects to RT and specifies follow up visit times. The RD assigns a level on the first pt visit which may change as pt's side effects change. Side effects= anorexia, dysphagia, xerostomia, dysgeusia, nausea, vomiting, diarrhea, and weight loss. Levels: 1) no side effects reported; visit every 10–15 days. 2) side effects reported, tolerates food: visit every 7–10 days. 3) side effects reported, poor tolerance to foods, use nutrition formulas; visit every 6–7 days. 4) unmanageable side effects, poor tolerance to nutrition formulas; visit every 2–3 days. This study examined the number of follow up visits in the 2 months before the implementation of the LOC (pre) and 2 months following the implementation (post). Subjects were outpatients who were free living—responsible for their own oral diet (n=87; pre=49; post=38; males=57; females=30; mean age=64; r=30–89). Subject's treatment sites: chest (C) n=36. neck (N) n=35, and pelvis (P) n=16. 60% pre vs 62% post LOC pts had follow up visits. Mean total visits with the RD was 2.3±0.3 pre vs 2.1±0.2 post LOC. Mean days between follow up visits were 11.3±1.7 pre vs 13.6±5.2 post LOC. Mean weight loss (pounds) was 4.0±1.4 pre vs 4.5±1.7 post LOC. The majority of pts post LOC were classified with a LOC=2 (LOC 1=13%, 2=46%, 3=41%, 4=0). Time guidelines for follow up visits were not met in 54% of visits post LOC. 40% of pre vs 38% of post LOC pts were seen only once by the RD. Post LOC, 80% of the single visits were with pts with a LOC of 1 or 2, indicating the pt tolerated foods, vs 20% of the pts who were LOC 3 (at any time during RT). With the implementation of Levels of Care, the RD could better identify pts at risk. While it is the goal of the RD to see pts as frequently as possible, increased visits do not always result in the prevention of side effects, especially weight loss. The LOC resulted in a small increase in follow up visits but the mean days between visits increased slightly as did mean weight loss.