*Diabetes Education Forms

If you registered for one of the face-to-face classes, you’re finished. We look forward to seeing you at the time and location you selected.

If you registered for On-line Education/Web-based Education, download the following form for the session for which you signed up, 1) download the file and save it to your computer, 2) reopen the file from your computer, 3) fill it out and make sure you save it before you close it, and 4) upload it here:

Upload files

If you signed up for Diabetes…Just the Basics, we need:

Telehealth Informed Consent Form; Notice of Privacy Practices Receipt

If you signed up for Healthy Living With Diabetes, we need:

Diabetes Education Assessment; Notice of Privacy Practices Receipt; Authorization for Release/Acquisition of Patient Information; Telehealth Informed Consent Form; Authorization for Media Release

You will receive an email with the link to your course a day or two before it is scheduled. The link will become live a few minutes before the session is scheduled to start. We utilize the Zoom platform for On-line meetings. If you have any problems or questions, submit them by using the form below:

Please verify that you are a human being: