Important COVID-19 Notice
Create a referral form using this sample template. Work with your appropriate internal departments (e.g., legal, risk, IT) to create a referral process for your organization that is compliant with applicable laws.
This information is not intended as a substitute for the medical advice of a physician; it offers no diagnoses or prescription. No endorsement is implied or intended by the American Medical Association or the North Carolina Medical Association of any third-party organization, product, drug, or service. Adherence to a lifestyle change program may not achieve desired diabetes results in every situation. The ultimate judgment regarding the appropriateness of any specific therapy must be made by the physician and the patient in light of all the clinical factors. The patient should check with their insurance provider for exact lifestyle change program costs and/or rates.
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