Provider Forms Pre-Appointment Assessment Form
Our self-management program is recognized by the American Diabetes Association; an organization that sets the gold standard for excellent diabetes care through education, experience and credentialing. The focus of the program is based on your individual needs and personal goals and may include one or all of the following:
- Healthy eating
- Being active
- Glucose monitoring
- Medications
- Problem solving
- Risk reduction
- Healthy coping
Translation services are available for any language. Videos and printed materials are also available for a variety of different languages.
A physician's referral is required before you can make an appointment. Please ask your physician to fax an order for Diabetes Education to (713) 242-3964. Diabetes Self-Management Education is covered by most insurance companies.
What to Bring to Your Appointment
- Your questions and concerns
- If you are already checking your blood sugars, please bring your blood sugar meter and logbook.
- Your most recent lab work, if available
- Your medication list (if applicable)
- You are welcome to bring a friend or family member for support.
Directions
The Diabetes Center is located inside Memorial Hermann Memorial City Hospital at 920 Frostwood Drive, Houston, TX 77024, in the West Pavilion. Free parking is available in the open lot directly in front of the West Pavilion entrance. As you enter the sliding glass doors, you will be greeted by our friendly employees at the Information Desk to begin your registration process.
To schedule an appointment: (713) 897-2514
For more information: (713) 242-3890 Fax: (713) 242-3964
Virtual Support Group
Virtual support groups are available every other month via Zoom from 6 p.m. - 8 p.m, click here to for dates and registration information.
Please download this form to attend the virtual group and email completed form to DiabetesEducators@memorialhermann.org.