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Home
Our Vision
Evidence
Blog
Team
Contact Us
Get Started
Clinician Patient Referral
Patient Sign up
member login
Virtual Connections. Real Life Results.
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Patient Advisor Sign up Form
Do you have Type 2 diabetes?
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Yes
No
Pre-diabetes
Unsure
Are you a Kentucky resident?
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Yes
No
First Name
Last Name
Mobile
+1
Email
Do you have a friend or family member who might be interested in becoming a patient advisor?
(Please provide the name, number and/email for that person or people)