Diabetic Patient Info
Please bring your meter and log to each appointment along with your medication list.
Education for Diabetic Patients:
You may be asked by your physician to schedule diabetic education in either an individual setting or a group setting. Individual education can take up to one hour initially and may require additional follow up visits of up to one hour each visit. Group education is a two hour class initially and may require individual follow up visits.
Insurance Relating to Diabetic Education:
It is our suggestion that before you attend an education session you contact your insurance company to check on your benefits and coverage. You will be responsible for any amount that your insurance company does not pay for. Since coverage varies, for your convenience we have developed a form with additional information and a list of questions to ask your insurance company regarding coverage for diabetic education. We can not guarantee that your insurance will cover your diabetic education. Patients are responsible for balances that the insurance does not pay.
Diabetic Education Insurance Coverage Form > Download (PDF)
Insurance Relating to 72 Hour Glucose or I-Pro Sensor:
We recommend that you contact your insurance company to verify if your insurance plan covers the 72 hour glucose monitor or I-Pro and what those benefits may be. We have developed a list of questions that you can ask your insurance company to help you determine what your insurance plan covers. We can not guarantee that your insurance will cover your Continuous Glucose Monitoring System or I-Pro. Patients are responsible for balances that the insurance company does not pay.
72 Hour Glucose or I-Pro Sensor Insurance Coverage Form > Download (PDF)
Diabetic Care Schedule:
The Diabetic Care Schedule will give you general information on how frequent a variety of exams and lab tests should be done and the recommended goals for test results.
Diabetic Care Schedule > Download (PDF)
Food & Activity Record:
This food & activity record is a tool to help keep track of total carbohydrates consumed in a day and blood sugar levels. Bring this into your appointment as your doctor requests it.
Food & Activity Record > Download (PDF)
Gestational Diabetes (GDM) Blood Glucose Record :
Designed for GDM patients to help track blood sugar levels before and after meals.
GDM BG Record > Download (PDF)
Blood Glucose Record :
Track blood sugar levels before and after meals.
Blood Glucose Record > Download (PDF)
Diabetic Flow Sheet for Insulin Pump:
Hourly chart for keeping track of blood sugar, carbs, meal bolus, correction bolus, and basal rate. Fill out this sheet and bring it in when your doctor requests it.
Diabetic Flow Sheet for Insulin Pump > Download (PDF)
Diasend Clinic ID #. 11-58094