Checkout – Sioux County Community Health Partners

View cart “Class Registration – In-Person, starting 09/22/2022, 5:30-6:30pm @ Sioux Center Health” has been added to your cart.

First name *

Last name *

Company name (optional)

Country / Region *

Street address *

Apartment, suite, unit, etc. (optional)

Town / City *

State *

ZIP Code *

Phone *

Email address *

Create an account?

Account username *

What program are you registering for? (optional)

Age *

Who Referred You? (optional)

BMI > 24 (or BMI > 22 for Asian Americans) *

Height (Inches) *

Weight (Pounds) *

Have you been told by your provider that you have prediabetes, elevated blood sugar, or borderline diabetes? *

What type of blood tests was performed? *

Have you ever been told that you had gestational diabetes mellitus (GDM) during pregnancy? *

Risk score qualification *

Product	Subtotal
Class Registration - In-Person, starting 09/22/2022, 5:30-6:30pm @ Sioux Center Health × 1 Program: In-Person, starting 09/22/2022, 5:30-6:30pm @ Sioux Center Health	$200.00
Subtotal	$200.00
Total	$200.00

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Please send a check to Community Health Partners, 211 Central Ave SE, Orange City, Iowa 51041

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