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 or text 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 24 months.If you have a history of Gestational Diabetes (GDM), and have received a letter from your GP about our service, please give us a call on 0333 577 3010 or email info@preventing-diabetes.co.uk and our Patient Support Team can register you or answer any questions you may have.

Please do not complete this form if you have already registered with Health & Wellbeing– 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

Register your details online

Title

First Name

Last Name

NHS Number

E-mail

Telephone

Mobile Number

You would like us to leave a voicemail on

Post Code Lookup Address

Address Line 1

Address Line 2

Address Line 3

Town or City

County

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

Are you a referring a patient on behalf of an organisation?