Diabetes Self-Management Program Workshop Registration
Diabetes Self-Management Program (DSMP) is an evidence based program developed by Stanford University as a tool to help people with chronic health conditions. Classes are highly participatory. Mutual support in the group builds participants’ ability and confidence to manage their chronic condition.
Anyone with diabetes or helping to care for a person with diabetes is welcomed to participate, with the following requirements:
1. Commitment to attend all 6 classes online
2. Be interactive in class
3. Do the homework after each class
4. Fill out all the required forms
Workshop Timing: 7/15/2021-8/19/2021, Every Thursday, 3:00-5:00 PM for six weeks
JOIN US and Live a Healthy Life with a Chronic Condition!
We look forward to meeting you!
Contact Hsiaoyin Chen-LMSW at (301) 820-7200 ext 8205 or
for any questions.
Date of Birth
Street Address, Apt/Unit #, City, State, Zip Code
What is the highest grade or year of school you completed?
Some elementary, middle, or high school
High school graduate or GED
Some college or technical school
College 4 years or more
Are you of Hispanic, Latino, or Spanish origin?
What is your race? Mark all that apply.
American Indian or Alaska Native
Black or African American
Native Hawaiian or other Pacific Islander
Have you ever served in the military?
What health insurance do you have? Please check all that apply:
Medicaid or Medical Assistance
Veteran’s or VA
Alternative Contact Person
Alternative Contact Person Phone
Never submit passwords through Google Forms.
This form was created inside of Chinese Culture and Community Service Center, Inc..