Rewind Diabetes Prevention Program Registration

Rewind Diabetes Prevention Program Registration

This is a 1 year virtual group-session based program using CDC approved curriculum. Sessions are conducted every week (typically Monday evenings), and submission of weight and physical activity minutes will be required each week. Join a community going through similar challenges as you and access education and support by one of our dietitians!
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
E-mail*
example@example.com
Do you have diagnosed Prediabetes or Type 2 Diabetes?*

PrediabetesType 2 DiabetesI'm not sureI don't have diabetes or prediabetes
What is your weight?*
in pounds
What is your height?*
What type of insurance do you have?*

BlueCross BlueShieldEmployer / Commercial / Private through other carriers (United, Aetna, etc)MedicareMedicaidUninsuredNot sureOther
How did you hear about us?*
Thank you! After clicking "Submit" you will be redirected to a Zoom registration page, where you can select your Intro Session date.

If you have any questions or need help registering, please email us at hello@joinrewind.com.
Should be Empty: