Register your details online

If you are a healthcare professional referring on behalf of a patient please ensure consent is gained before proceeding with the referral.

If your GP has sent you a letter which confirms that you are at risk of Type 2 diabetes, you are able to register for the Healthier You: NHS Diabetes Prevention Programme. To be able to register online you will need the following information found in your letter:

Your NHS number, latest HbA1c or FPG reading, including the date and your GP surgery name

These are required fields, and referrals without this information cannot be processed. To be eligible for this programme your HbA1c must be between 42-47 mmol/mol or Fasting Plasma Glucose between 5.5-6.9 mmols/l and dated within the last 12 months.

Please do not complete this form if you have already registered with ICS – registering a second time could delay your referral.

If you have been issued with a Service User ID (e.g. su4fum), this confirms your registration on to the diabetes prevention programme and you do not need to complete this form. If you want to confirm you are interested in the programme, you can do this here – please note you will need your Service User ID to do this.

Register your details online

Title

First Name

Last Name

NHS Number

E-mail

Telephone

Mobile Number

What is your preferred contact number?

You would like us to leave a voicemail on

Address Line 1

Address Line 2

Address Line 3

Town or City

County

Post Code

Gender

Date of Birth

Where is your GP located?

Do you speak English?

What is the your first language?

Which blood test results will you provide?

Search for your Surgery e.g. Surgery Name, Town, Postcode