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
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.
