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Are you at-risk for type 2 diabetes?
Take this secure CDC risk assessment survey to see if you are eligible to participate in the YMCA's Diabetes Prevention Program -- all adults over the age of 18 are eligible to apply.
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Email *
Name *
Phone Number *
Do you have a mother, father, sister, or brother with diabetes? *
Have you ever been diagnosed with high blood pressure? *
How old are you? *
What race or ethnicity best describes you? *
Are you physically active? *
Are you a female or male? *
If you selected female: Have you ever had gestational diabetes? (diagnosed through pregnancy)
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How tall are you? *
How much do you weigh? *
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