CCACC Health 2022 Workshop Sign-Up Form
CCACC Health Center will provide 6 workshops to our community in 2022 to improve the quality of life of patients who have diabetes, chronic pain, or dementia. Their caregivers are also welcome to join the workshop to learn self-management strategies.  
All workshop participants are encouraged to complete the pre and post forms to help us do a better work.
Please select the workshops which you are interested in, and we will contact you for further steps.
To learn more, please visit or call 240-393-5950 or mail to 
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I am interested in joining the workshop(s): 我想參加的課程為: *
First Name 名字 *
Last Name 姓氏 *
Sex 性別
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Date of Birth 生日
Phone Number 電話 *
Email 聯絡電郵 *
Address 地址
What health insurance do you have? Please check all that apply: 請問您的醫療保險種類為 *
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