Beyond Barriers Application

General Information

Clinic or Organization(Required)

Contact(Required)

Email(Required)

Phone(Required)

Address(Required)

Overview of Innovations

Approaches(Required)

What approaches is your organization currently implementing in the field of diabetes education or technology usage to assess risk and improve outcomes for your patient population?

Technology Services

Are you leveraging AI, technology or electronic medical records in a unique way to enhance your diabetes care services?

Yes

Diabetes Education and Management Programs

Does your organization provide diabetes self-management courses for individuals newly diagnosed with diabetes?

Yes

Self-management Programs(Required)

Could you provide a brief overview of your diabetes self-management program?

Learn More About Self-management Programs

Would your organization be interested in learning more about the Beyond Type 1 self-management program, Beyond Diagnosis and potentially incorporating some of its elements into your patient outreach services?

Yes

Reducing Diabetic Ketoacidosis (DKA)

Reducing Diabetic Ketoacidosis (DKA)(Required)

What strategies or initiatives has your organization implemented to reduce the incidence of Diabetic Ketoacidosis (DKA) among your patient population?

Warning Signs Awareness

Does your organization have policies in place to effectively communicate the warning signs of diabetes to all members of your patient population?

Yes

Patient Demographic Data

Reach (# of population served)(Required)

Age Range (ex: 18-65)(Required)

Ethnicities Served(Required)

American Indian or Alaskan Native

Asian

Black or African Descent

Hispanic

Native Hawaiian or Pacific Islander

Other

Prefer not to say

White (Caucasian)

Are your patients...?(Required)

Would you like to become a #SeeTheSigns Ambassador?

Yes

Learn More