The following forms and information are required for all programs except the Pre-diabetes Program. If you have questions, contact the Inova Diabetes Center location where you will be receiving services.
Steps to register for classes
Cómo registrarse para el programa de educación en diabetes
- Ask your physician to complete an order form.
Print a physician order form
for diabetes education to take to your doctor. Inova Diabetes Center requires an order form from your doctor to provide services.
- Choose a location.
Find the location for the class or program that interests you and call to reserve a spot.
- Check with your insurance company about coverage.
Some insurance companies also require pre-authorization to cover our services.
- Complete an assessment form
We can mail, email or fax the appropriate assessment form to you. Or, you may download the needed forms below. If you have not completed the assessment form prior to your appointment, please arrive 20 to 30 minutes early to allow adequate time to complete the form.
Assessment forms
- If requested, complete a three-day food and activity record.
You may be asked to complete a 3-day food and activity record prior to your appointment. Record your food, beverage and portion sizes on this food record sheet and bring with you.
- Bring any available current laboratory results, such as hemoglobin A1C, glucose and lipid profile.
- Bring your insurance card(s) to each visit.
- Bring your blood glucose meter to your appointment.
If you do not have a blood glucose meter, we will try to provide you with one.
