Registration Form

Diabetes Classes (Recorded) Registration

This registration form is to be filled out and submitted by the participant. Please fill out the following to participate in our program and to receive the links to the recorded classes:

  • Those participating from home may provide their home address.
  • Please select the recorded tele-education classes you would like to view. Press and hold the COMMAND/ALT key and click on the class to make multiple selections.
  • Confirmation of Registration

    After submitting this registration form, you will receive an email with links to the videos and the handouts. This program is free to all residents. Please contact Lorrie Rilko with any questions at