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PRE Diabetes Reassessment Please fill out all the information on this form and bring it with you to the appointment Name: Date of Birth: Date: Referring Physician: Primary Care Physician: Height:
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How to fill out pre diabetes self-assessment

01
Start by gathering all the necessary information for the pre diabetes self-assessment.
02
Begin by answering each question honestly and thoroughly.
03
Take your time to carefully read and understand each question before providing an answer.
04
If you are unsure about a specific question, it is recommended to consult with a healthcare professional for clarification.
05
Progress through the self-assessment form, ensuring you are providing accurate and up-to-date information.
06
Once you have completed filling out the self-assessment form, review your answers for any errors or inconsistencies.
07
Make sure to submit the completed form as instructed, whether it is through an online platform or by hand.
08
After submission, await the results of the self-assessment. If necessary, follow up with a healthcare professional for further guidance or assistance.
09
Keep a record of your self-assessment results for future reference and monitoring of your pre diabetes status.
10
Periodically revisit the self-assessment process to track any changes in your pre diabetes risk factors and take necessary actions accordingly.

Who needs pre diabetes self-assessment?

01
Individuals who have risk factors for pre diabetes, such as being overweight or obese, having a family history of diabetes, and leading a sedentary lifestyle.
02
People who are concerned about their blood sugar levels or who have been advised by a healthcare professional to assess their pre diabetes risk.
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Those who would like to proactively monitor their health and take preventive measures to avoid the development of type 2 diabetes.
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Individuals who want to understand their pre diabetes status and make lifestyle changes to improve their overall well-being.
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People who are interested in learning more about pre diabetes and its associated risk factors.
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Pre diabetes self-assessment is a questionnaire or tool used to assess an individual's risk of developing type 2 diabetes.
Anyone who falls within the high-risk category for developing type 2 diabetes is encouraged to file a pre diabetes self-assessment.
To fill out a pre diabetes self-assessment, one must answer questions regarding their age, weight, family history of diabetes, physical activity level, and other relevant factors.
The purpose of pre diabetes self-assessment is to identify individuals who may have a high risk of developing type 2 diabetes so that they can take preventive measures.
Information such as age, weight, family history of diabetes, physical activity level, and other relevant health factors must be reported on a pre diabetes self-assessment form.
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