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Physician & Organization Referral

one-pageThe Diabetes Prevention Program (DPP) aims to prevent individuals with prediabetes, or otherwise at high risk, from developing diabetes. Those who are already diagnosed with Type 1 or Type 2 diabetes do not qualify. However, we plan to offer a Diabetes Self-Management program in the near future. 

The Fallbrook Regional Health District  Lifestyle Change program is part of the Centers for Disease Control and Prevention-led National Diabetes Prevention Program.

Download our one page program overview: 

DPP program overview.pdf

 

It's easy to refer to our Lifestyle Change program in one of two ways:

 

1. Complete the form below and print the informational flyer for your patient/client or add it to their after-visit summary.

DPP Lifestyle Flyer.pdf
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OR

 

2. Download our Referral Form and return it by FAX or email. The second page is an informational flyer for the patient.

Lifestyle Change Physician Referral Form & patient flyer.pdf

 

FAX (760) 731-9131

Email: tgeracitano@fallbrookhealth.org

 

Please check the referred patients' A1c levels at the time of referral, at 6 months into the program, and upon completion of the program at 12 months. Please also provide the patients with a copy of these results. Their lifestyle coach will monitor their progress.