diabetes pump education

This information is for diabetes patients who are considering getting an insulin pump to help manage their diabetes. Please watch the 45 minute video by our diabetes nurse, then complete the form below. We will then send you homework to complete. You can also watch these videos from MiniMed, Tandem and Omnipod, and download the presentation from the video below.

Watch this video to learn about different insulin pumps, then fill out the form below.

name/date

today’s date:

child’s first and last name:

mailing address:

contact information

Select if you want homework to be mailed to your home or sent in MyKidsChart

By checking this box, I confirm that I have watched the pump education training and am ready to receive the homework to the email address I've provided.

confirmation

By checking this box, I confirm that I have watched the pump education training and am ready to receive the homework to the mailing address I've provided, or to my MyKidsChart account.

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