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VCE Diabetes Prevention Program Interest Form
Thank you for your interest in the Virginia Cooperative Extension Diabetes Prevention Program (DPP). This proven program is for people with prediabetes who are overweight. It helps them make changes in their lifestyle to lose weight and reduce the risk or delay the onset of diabetes.

The program is offered online or in person. Groups meet for one year, starting with weekly meetings, then every other week, with the last 6 months meeting monthly. Currently there is no charge for joining the program. All program costs are being covered by a grant from the Virginia Department of Health.

If you are at risk of diabetes and are interested in joining this program, please provide the information requested below. We will contact you to answer any questions you have about the program and begin the registration process.
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Name *
Phone Number
Virginia County or City of Residence *
Have you been told by a healthcare provider that you have pre-diabetes, elevated blood sugar, gestational diabetes, or borderline diabetes?
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What day of the week do you prefer? (choose all that work for you)
What time of the day do you prefer? (choose all that work for you)
How did you hear about the VCE Diabetes Prevention Program?
Feel free to add any questions you have about the program that we can discuss when we follow up with you.
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