My Diabetes Connect

Birmingham’s Guide

to local diabetes resources

ESPAñOL

Submit A Resource

Please complete the following information about your organization’s health and wellness resources, offerings and programs designed to help people in Birmingham reduce their risk of developing diabetes or manage their diabetes. In the event that you don’t have complete information, please submit the form anyway. We will do our best to follow up and complete the information. Any resource that can help people reduce their risk of developing diabetes or manage diabetes is of interest. We are working on a variety of ways to help our physicians and our citizens learn about all of the opportunities available.

General Information (Required Fields Marked with an *)

Community Resource Name*
Street Address
Pick Community
Pick Neighborhood
Zip Code
Resource's Contact Name*
Resource's Email Address
Resource's Phone Number
Resource's Fax Number
Resource's Website
Include an Image or Logo
Is resource individual or group based?

Pricing and Scheduling

Is there a fee for this resource?
If there is a fee, please describe it here.
Is scholarship or financial assistance available?
Does the resource meet on an ongoing basis or is it scheduled to start and stop?
Is physician referral required?
Resource Scheduling Options
Event Start Date
Event End Date (optional)
What days of the week is this resource available?
What day of the month is this resource available?
Full Event Schedule

Please enter the start and end times for each day or days of your event as selected above as well as any other relevant info about your event's schedule.

Full Resource Schedule

Please enter the full availability of this resource such as meeting times, business hours, or any other relevant info about your resource's schedule.

Categorization and Description (Select at least one)

Please select at least one category for your resource.
Healthy Eating
Physical Activity
Healthy Families
Support + Education
Healthcare
Research Opportunities
More
Resource description*
Any other information that you wish to include