Diabetes Prevention Programs

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Three cohorts will begin in early 2022. Choose from one of the following.

Cohort 1
Date: Mondays, March 7, 2022 to February 2023 – one-year program
Time: 5:30 to 6:30 p.m.
Location: Virtual
Coach: Laurin Plummer

Cohort 2 - FULL

Cohort 3 - Full

Please complete the registration information below.

Mark the class you are registering for: *

Mondays, March 7, 5:30 to 6:30 p.m. - Coach Laurin Plummer

I prefer the following type of class *

Face to Face

Virtual

Name *

Preferred name

Phone *

email *

Have you ever been told by your doctor that you have prediabetes? *

Yes

Have you ever had a blood test that shows that you have prediabetes? *

Yes

Have you ever had gestational diabetes? *

Yes

Are you "at risk" for diabetes according to the CDC Diabetes Risk Test? (If you don't know, take the test at https://www.cdc.gov/prediabetes/takethetest/) *

Yes

What is your ethnicity? *

Hispanic or Latino

Not Hispanic or Latino

Prefer to not answer

What is your race? *

American Indian or Alaska Native

Asian or Asian American

Black or African American

Native Hawaiian or Other Pacific Islander

White

With which gender do you identify? *

Male

Female

Other

Prefer to not answer

How old are you? *

What is your education level? *

Less than grade 12 (No high school diploma or GED)

Grade 12 or GED (High school graduate)

College - 1 year to 3 years (Some college or technical school)

College - 4 years or more (College graduate)

Do you have a physical disability or visual impairment?

Physical Disability

Visual Impairment

None

What is your height in inches? *

What is your initial starting weight? *

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