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Diabetic Clinic Referral

Diabetes is a complex disease affecting many functions of the body.  Many residents of the Metro area suffer with this disease and those with limited access to health care services are at the highest risk for developing complications.  In an effort to help prevent complications, the Pro Bono Clinic offers a Diabetic Clinic once a month. During this clinic the Physical Therapist or Podiatrist staff performs a screen of the lower legs identifying individuals at risk for diabetic neuropathy and peripheral artery disease.  At the same time, an Ophthalmologist performs an eye screen for diabetic retinopathy.

To refer a patient for the Diabetic Clinic, please fill out the form below and click SUBMIT REFERRAL at the end of the form.  You will receive a confirmation email.  The form will clear after you submit so you can enter another patient. The patient will be  scheduled for the next available clinic.  If you have questions about a referral you can click here: Clinic Administrator.

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