Certified Diabetes Educator (CDE) Referral Form

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Author: Chautauqua County Health Department (NY)

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Certified Diabetes Educator CDE Referral Form 1 id2454

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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.

Program: Community Health

Submitted Date: Apr 18, 2011 | Modified Date: Sep 30, 2025

Primary Toolkit: Chronic Disease Prevention Toolkit | Secondary Toolkit: N/A

Jurisdiction:

Institution Type: LHD - County,

Keywords: Chronic Disease, Healthy Living & Prevention

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