Health Department Registration Form
Free Diabetes Classes on the Road Outreach Program
If you wish to register for free diabetes
classes, please complete the following form. Seating is limited
and registration is required.
Registrants should be age 18 years and over diagnosed with
diabetes, or family members and/or care givers to those
diagnosed with diabetes.
You will receive a follow-up phone call and/or e-mail to
confirm your registration.
All fields are required.