Medical Provider Information
Referrals:
If you are a provider and would like to refer one of your patients to our Diabetes Self-Management Education program, you can follow the easy steps below:
- Diabetes Self-Management Education Referral
- Referral instructions
- Complete the Referral and accompanying information and fax to 336-401-8408. If you have questions, please call 336-401-8419.
Upon receipt of the referral and referral information, a member of the Diabetes Self-Management Education Program management support team will:
- Contact the patient to schedule an initial assessment with our dietitian and our nurse
- Notify your office by fax of the appointment date and time
- Notify your office if the patient does not keep the appointment
- Update you, via fax, with a plan of care made by our nurse and dietitian which will include education provided and goals specifically designed for your patient
We Value Your Suggestions!
Once a year the Diabetes Self-Management Education Program will ask your office to complete a brief
survey regarding the service you and your office staff receive. We will compile feedback from the surveys received and report back to you our plan of action to help enhance the service you receive to optimize your patient’s success.
Twice a year, we also survey patients who attend appointments and classes in our Diabetes Self-Management Education Program for their input to measure the success rate according to the patient perspective. These results are a valuable part of our program’s strategic goal planning.
CONTACT US:
Diabetes Self-Management Education
Surry County Health & Nutrition Center
118 Hamby Road
Dobson, NC 27017
Telephone: 336-401-8419
Fax: 336-401-8408
