New Orleans Health Department Diabetes Prevention Program

Interest Form

The New Orleans Health Department is an approved provider of the CDC's National Diabetes Prevention Program (or DPP). This is a 12-month program and full commitment is required. Services are free and provided in-person at locations that will be determined based on availability. We are accepting participant referrals on a rolling basis. If you are interested in this Diabetes Prevention Program, please fill out the form below and you will be contacted for follow-up.
1.What is your name?
2.What is your email address?
3.What is your phone number?
4.Are you over 18 years old?
5.Do you have a body mass index (BMI) of 25 or higher (23 or higher if you're an Asian American person)?
6.Have you been diagnosed with type 1 or type 2 diabetes?
7.Are you pregnant?
8.Have you had a blood test result in the prediabetes range within the past year?
9.If you had a blood test result in the prediabetes range in the past year, which test did you complete?
10.Have you been previously diagnosed with gestational diabetes (diabetes during pregnancy)?
11.Did you receive a high-risk result (score of 5 or higher) on the CDC's Prediabetes Risk Test?