Diabetes Alliance Network Program Brochure

Page 1

GET

COLLABORATION

STARTED

FOR GOOD

DSME REFERRAL

These regional and national organizations are combining forces to support the Diabetes Alliance Network by providing health and wellness services that help individuals stay healthy and live well with diabetes.

PATIENTS: Have your doctor or physician fill out this referral form prior to contacting DAN for session dates and locations

NATIONAL AFFILIATES

PHYSICIANS: This referral enables your patient to receive 10 hours of Diabetes Self Management Education that meet the National Standards for Diabetes Self-Management Education and receive Support from the American Diabetes Association.

SOUTH FLORIDA

CONTACT US PATIENT

DATE

*The American Diabetes Association Recognizes this education service as meeting the National Standards for Diabetes Self-Management Education and Support.

REGIONAL AFFILIATES REFERRING PHYSICIAN

CLINIC OR PRACTICE NAME

PHYSICIAN SIGNATURE WHEN COMPLETE, CONTACT US FOR CLASS DATES & LOCATIONS

888-CALL-DAN

Professionals Aligning Services to Offer an Improved System of Care

Learn more about DAN, our programs, partners and upcoming class dates and locations.

888-CALL-DAN FINDMyDan.com

health care network of southwest florida

888-CALL-DAN FINDmydan.com


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