Thank you for taking the time to complete the DPAC content expertise form. We will use this information for the creation of Advisory Panels to address changes in diabetes science, guidelines or help with Coalition communication needs. This information will NOT be shared with other organizations, or used for any marketing or outreach efforts.

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* 1. Please complete the following:

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* 2. What type of organization do you represent?

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* 3. What is your primary area of expertise?

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* 4. Please select your areas of expertise in diabetes prevention and management

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* 5. Please note other areas of expertise you have that contribute to effective diabetes management and/or its prevention? (Examples may include: community health worker, use of telemedicine, engagement or pharmacists, etc.)

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* 6. Would you like to participate on the 2019 DPAC Forum (conference) Planning Team?

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* 7. Do you have suggestions for conference topics or speakers for the 2019 DPAC Forum?

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* 8. Do you have any other comments or suggestions to share with us?

Thank you for taking the time to complete this form. If you have questions, suggestions or need more information, please contact Amy Stagg at stagga@michigan.gov or 517-324-7310.

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