ECHD Prediabetes Screener

  • ECHD Prediabetes Nutrition Program

    Complete this brief questionaire to see if you are eligible for subsidized Registered Dietitian visits through the El Camino Healthcare District's prediabetes nutrition program with Season Health. 

    Season Health is a third-party partner of El Camino Healthcare District. 

  • What is your date of birth? *
     - -
  • Format: (000) 000-0000.
  • Have you ever been told by a medical professional that you either have prediabetes or are at risk of developing prediabetes?*

  • To be eligible for the El Camino Healthcare District's Prediabetes program, you must live or work within the El Camino Healthcare District. If you're not sure, you can check by entering your home or work address in the ECHD Boundary Map! Even if you are not eligible for the subsidized program, you may be eligible for coverage through your insurance.

  • Do you live OR work in any of the zip codes listed below?*
  • How old are you?*
  • Are you a man or a woman?*
  • If you are a woman, have you ever been diagnosed with gestational diabetes?*
  • Do you have a mother, father, sister or brother with diabetes?*
  • Have you ever been diagnosed with high blood pressure?*
  • Are you physically active?*

  • Find your weight category based on the chart below:

  • What is your weight category? See chart above.*

  • Your privacy is important to us. Your information is protected under HIPAA and used only for your care and related operations. We do not sell or share your personal health information with marketers or third parties.

  • Should be Empty: