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Live Well Diabetes Prevention Program REGISTRATION FORM TODAYS DATE:ADDRESS:NAME:FREEPHONE:CITY, STATE, ZIP VOICEMAIL:PREFERRED CONTACT METHOD (for class dates and information):DATE OF BIRTH:AGE:SEX:
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Start by gathering all the necessary information such as personal details, medical history, and contact information.
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Read each question carefully and provide accurate answers. It is important to be honest and provide all the required information.
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Who needs live well diabetes prevention?

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Live Well Diabetes Prevention is beneficial for individuals who have a high risk of developing diabetes or those who want to prevent diabetes. People who may benefit from this program include:
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- Individuals with pre-diabetes or borderline high blood sugar levels
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- Overweight or obese individuals
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- People with a family history of diabetes
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- Individuals with sedentary lifestyles and poor eating habits
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- Those with other risk factors such as high blood pressure or high cholesterol levels
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- Anyone who wants to lead a healthier lifestyle and reduce their risk of developing diabetes
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Live well diabetes prevention is a program aimed at promoting healthy lifestyle choices to prevent or manage diabetes.
Individuals who are at risk of developing diabetes or those looking to manage their diabetes are encouraged to participate in the Live Well Diabetes Prevention program.
To fill out the Live Well Diabetes Prevention program, individuals can contact their healthcare provider or local community health center for more information.
The purpose of Live Well Diabetes Prevention is to educate individuals on how to make healthy lifestyle choices to prevent or manage diabetes.
Information that may be reported on Live Well Diabetes Prevention includes current health status, eating habits, exercise routine, and blood sugar levels.
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