Certified Diabetes Educator (CDE) Referral Form

Keywords / Description:

This referral form, created by Chautauqua County Health Department (NY), is a useful tool for use by medical providers to refer patients to Certified Diabetes Educators (CDEs). It provides the clinician with an easy-to-use chart for indicating:

Patient diagnosis,
Purpose of referral,
Results of lab work,
Diabetes complications,
Existing barriers to care,
Exercise prescription, and
Current medications.

Toolkit:

Chronic Disease Prevention Toolkit

Keyword Area:

Chronic Disease, Obesity

Jurisdiction:

100,000 - 149,999

Institutional Author:

Chautauqua County Health Department (NY)

Submitted:

04/18/2011

Modified:

01/10/2013

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