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2018 ABC's of Diabetes Class Registration

Welcome to the ABCs of Diabetes, a PCPS benefit implemented by the PCPS Employee Wellness Team. The ABCs assists employees and dependents participating in the School Board Health Plan who have been diagnosed with diabetes, best manage with on-going proactive education, support, and approved supplies and medications. The following classes are required for entry into the Program and may also be used as refresher education following year one. Please make note of your class choice, including time and location, as a reminder may not be provided. Questions? Call 863-648-3057 or visit http://www.polk-fl.net/staff/Employeeinfo/wellness/diabetes.htm. Thank you!

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* 1. Last Name

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* 2. First Name

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* 3. Worksite

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* 4. SAP number

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* 5. Phone Number

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* 6. Email address

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* 7. Mailing Address (street, city, zip)

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* 8. Which of the following applies to you?

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* 9. Are you a...

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* 10. Please sign me up for January opportunities at the Lakeland Employee Health Clinic--Education Room, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided. 

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* 11. Please sign me up for March opportunities at Bartow Airbase, 698 Cessna Street, Bartow, FL 33830. Please make note of your class choice, including time and location, as a reminder might not be provided.

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* 12. Please sign me up for the March Type 1 Support Group opportunity at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided. 

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* 13. Please sign me up for April opportunities at Lake Gibson Middle School, Media Center, 6901 N. Socrum Loop, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided. 

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* 14. Please sign me up for May AM opportunities at Tenoroc Transportation Service Center 4725 Saddle Creek Road, Lakeland, FL, 33801. Please make note of your class choice, including time and location, as a reminder may not be provided.

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* 15. Please sign me up for May PM opportunities at the Lakeland Employee Health Clinic 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided.

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* 16. Please sign me up for June 14, 2018 summer opportunities at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland (choose whichever sessions you desire)

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* 17. Please sign me up for June 14, 2018 summer opportunities at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland 

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* 18. Please sign me up for the July Type 1 Support Group opportunity at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided. 

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* 19. Please sign me up for July 19th, 2018 all day summer opportunities at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland (choose whichever sessions you desire)

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* 20. Please sign me up for August opportunities at the Lakeland Employee Health Clinic--Education Room, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided.

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* 21. Please sign me up for the September Type 1 Support Group opportunity at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided. 

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* 22. Please sign me up for September opportunities at the Mark Wilcox Center, 611 Post Ave SW, Winter Haven, FL 33880. Please make note of your class choice, including time and location, as a reminder may not be provided.

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* 23. Please sign me up for October opportunities at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided.

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* 24. Please sign me up for the November Type 1 Support Group opportunity at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder may not be provided. 

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* 25. Please sign me up for November opportunities at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder might not be provided.

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* 26. Please sign me up for December opportunities at the Lakeland Employee Health Clinic, 3215 Winter Lake Road, Lakeland, FL. Please make note of your class choice, including time and location, as a reminder might not be provided.

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