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Adobe PDF   Diabetes Education ChecklistThe file you are about to download will ONLY work properly if opened with an Adobe Reader 10 or later client. Please do not open this file in a browser.Fill, Print & Save1966.0 kb

Form Classification
Classification / Identification:
 Form Number:4969-47EEdition date: 2016/07 
 Title:Diabetes Education Checklist
 Ministry:Health and Long-Term Care  
 Branch/ABC:Drug Programs Policy and Strategy Branch  
 Program:Ontario Public Drug Programs  
 Purpose of Form:The MedsCheck for Diabetes includes an Annual review that involves using the pharmacist's worksheet and providing the patient with a MedsCheck Personal Medication Record; as well as using a Diabetes Education Checklist and providing the patient with a Diabetes Education Patient Take-Home Summary.  

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