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DO NOT COPY THIS FORDHAM REGION DIABETES EDUCATION PROGRAM (DEP) REFERRAL FORM Client Name: M F DOB (dd/mm/by): Age: Parent/Guardian (if less than 18 years of age): Health Card #: Address: Phone (Home):
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First, gather all the necessary documents needed to fill out the Durham Region Diabetes Education form.
02
Open the form and read through the instructions carefully.
03
Start filling out the form by providing personal information such as your name, address, date of birth, and contact details.
04
Next, answer the questions related to your medical history and current diabetes condition.
05
Provide details about any medications or treatments you are currently undergoing for diabetes.
06
Include information about any allergies or dietary restrictions you have.
07
If applicable, provide information about your healthcare provider and their contact details.
08
Review the completed form to ensure all information is accurate and complete.
09
Submit the form through the designated channel as mentioned in the instructions.
10
Wait for confirmation or further instructions from the Durham Region Diabetes Education center.

Who needs durham region diabetes education?

01
Individuals diagnosed with diabetes who require education and support related to managing their condition can benefit from Durham Region Diabetes Education.
02
Anyone residing in the Durham Region and dealing with diabetes, whether newly diagnosed or with previous experience, can take advantage of the education provided.
03
Patients looking to learn more about diabetes self-management, dietary guidelines, exercise recommendations, and medication management can find value in this program.
04
Family members or caregivers involved in the care of someone with diabetes can also benefit from the education and support services offered by Durham Region Diabetes Education.
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Durham Region Diabetes Education is a program designed to educate individuals with diabetes on how to manage their condition effectively through proper diet, exercise, medication, and monitoring.
Individuals with diabetes who are residents of Durham Region are required to participate in the diabetes education program.
To participate in the Durham Region Diabetes Education program, individuals can contact their healthcare provider or the Durham Region Health Department to schedule an appointment for an assessment and education session.
The purpose of Durham Region Diabetes Education is to empower individuals with diabetes to take control of their health and well-being by providing them with the necessary knowledge and skills to effectively manage their condition.
The Durham Region Diabetes Education program requires individuals to report their blood sugar levels, medication usage, dietary habits, exercise routine, and any symptoms or complications related to their diabetes.
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