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April 2019 Diabetes Management Series Registration Form
The
Free
three-part Diabetes Management Series will be held on Thursdays April 11, 18 and 25 from 6:00-7:00
p.m. in the Knox County Health Department Auditorium.
*
1.
First Name:
(Required.)
*
2.
Last Name:
(Required.)
*
3.
Phone Number: (xxx-xxx-xxxx)
(Required.)
4.
How did you hear about our classes?
Newspaper
Workplace
Television/News
Facebook/Twitter
Word of mouth
Doctor's office (please list name in space below)
Other (please specify):
5.
Email:
6.
I would like to receive reminders about future diabetes management events.
Yes
No