I voluntarily agree to participate in the Diabetes Prevention Program (DPP)
through the Lake Cumberland District Health Department (LCDHD). I understand that I may code 1 hour per session that I attend as long as I maintain 75% attendance of all sessions. I have received my supervisor's permission to participate in the Life Change Program. (Attendance will be maintained by the Lifestyle Coach.) I also acknowledge that I have been provided a copy of the LCDHD Notice of Privacy Practices.