T2 Lifestyle Change Program Enrollment

About 1 out of 3 American adults have pre-diabetes, that’s 88 million people. People with pre-diabetes are at higher risk of heart attack, stroke and type 2 diabetes. Type 2 diabetes puts people at risk for many serious health problems including; heart attack, stroke, blindness, kidney failure, loss of limbs.

Fortunately, having prediabetes doesn’t guarantee a person will get type 2 diabetes. Type 2 diabetes can be prevented.

Studies show that “Prevent T2 Lifestyle Change Program” participants can cut their risk of developing type 2 diabetes by 58% and 71% for those over 60. Additionally, the program has also shown to reduce heart attack and stroke risk.

The Center for Black Women's Wellness, and Fulton County Board of Health is proud to offer this program to you, free of charge!  Please fill out the information below to enroll in the Prevent T2 program today!

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* 1. First Name

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* 2. Last Name

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* 3. E-mail Address

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* 4. Phone Number

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* 5. Date of Birth

Date

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* 6. What is your gender?

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* 7. Are you currently pregnant?

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* 8. What is your current residential address?

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* 9. County of residency:

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* 10. Zipcode

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* 11. Race (Check all that apply)

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* 12. What is the highest level of education you have completed?

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* 13. How did you hear about this program?

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* 14. Height

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* 15. Weight

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* 16. Has a healthcare provider told you that you have diabetes?

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* 17. Has a healthcare provider told you that you have prediabetes, elevated blood sugar, or borderline diabetes?

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