---
title: Diabetic Education Program Consent Form Template | Paperform
description: Professional consent and enrollment form for diabetes education programs. Collect patient information, medical history, treatment preferences, and HIPAA-compliant consent for glucose monitoring, insulin training, and nutrition counseling.
url: "https://paperform.co/templates/diabetic-education-program-consent-form"
type: static
generatedAt: "2026-03-28T00:43:40.213Z"
---

[← Back to free form templates](/templates/)    ![Diabetic Education Program Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/diabetic-education-program-consent-form.png)
    [Preview](https://_preview.paperform.co/ai-template/diabetic-education-program-consent-form) [Use this template for free](/create?ai-template=diabetic-education-program-consent-form)    [Healthcare & Medical Forms](/templates/category/healthcare/)[Legal & Compliance Forms](/templates/category/legal/) [Healthcare](/templates/industry/healthcare/)[Medical Devices](/templates/industry/medical-devices/) [Physician](/templates/role/physician/)[Nurse](/templates/role/nurse/)[Pharmacist](/templates/role/pharmacist/)[Healthcare Administrator](/templates/role/healthcare-admin/)[Dietitian](/templates/role/dietitian/)     About this free form template
Managing diabetes requires ongoing education, support, and clinical oversight. This **Diabetic Education Program Consent Form** streamlines enrollment for healthcare providers offering diabetes management programs, capturing patient information, medical history, treatment preferences, and informed consent in a single, HIPAA-compliant workflow.

Whether you're running a hospital-based diabetes education center, an endocrinology practice, or a community health clinic, this template helps you securely collect essential information before beginning glucose monitoring training, insulin administration education, nutritional counseling, and specialist referrals. Built with Paperform, the form includes conditional logic to tailor questions based on patient needs, ensuring every participant receives personalized care planning.

### Why Healthcare Providers Trust Paperform for Patient Consent

Paperform is designed for healthcare organizations that need secure, professional forms without the complexity of traditional medical software. This template is SOC 2 Type II compliant and includes features specifically valuable for diabetes education programs:

 - **Conditional logic** reveals relevant questions based on diabetes type, current treatment regimen, and complication history
 - **HIPAA-aligned data collection** with secure submission handling and encrypted storage
 - **Papersign integration** (papersign.com) lets you collect legally binding electronic signatures on consent documents, keeping everything linked to the original enrollment form
 - **Custom success pages** that confirm enrollment and provide next steps for patients
 - **Automated workflows via Stepper** (stepper.io) to route new enrollments to care coordinators, schedule initial assessments, and update your EHR or patient management system

### Built for Diabetes Care Teams

This template serves endocrinologists, certified diabetes educators, dietitians, nurses, and care coordinators who need to onboard patients efficiently while ensuring complete informed consent. Customize sections to match your program structure—whether you offer group classes, one-on-one counseling, or hybrid telehealth sessions—and use Paperform's doc-style editor to add your clinic branding, educational resources, and insurance information.

By centralizing consent and intake in one intelligent form, you reduce administrative burden, minimize errors, and help patients start their diabetes education journey with confidence and clarity.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
 ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg)
 ![G2 - 4.8 out of 5](/images/g2-st.jpg)
  [Try Paperform free now](/register)
## More templates like this
  [![Medical Equipment Rental Consent Form - Home Oxygen](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-equipment-rental-consent-form-home-oxygen.png)

### Medical Equipment Rental Consent Form - Home Oxygen

Comprehensive consent form for home oxygen equipment rental including delivery scheduling, safety protocols, emergency backup systems, and insurance billing authorization.](/templates/medical-equipment-rental-consent-form-home-oxygen/)
[![Cardiac Rehabilitation Program Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/cardiac-rehabilitation-program-consent-form.png)

### Cardiac Rehabilitation Program Consent Form

A comprehensive consent form for cardiac rehabilitation programs that includes patient intake, medical history, HIPAA authorization, treatment consent, exercise prescription acknowledgment, dietary counseling agreement, stress management participation, and insurance verification.](/templates/cardiac-rehabilitation-program-consent-form/)
[![Chemical Peel Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/chemical-peel-consent-form.png)

### Chemical Peel Consent Form

A comprehensive consent form for chemical peel treatments, covering skin damage risks, post-treatment care instructions, sun exposure restrictions, and healing timeline acknowledgments.](/templates/chemical-peel-consent-form/)
[![Dialysis Treatment Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/dialysis-treatment-consent-form.png)

### Dialysis Treatment Consent Form

A comprehensive consent form for dialysis treatment that covers vascular access options, treatment schedules, dietary restrictions, HIPAA authorization, and transplant list eligibility discussions.](/templates/dialysis-treatment-consent-form/)
[![Laser Eye Surgery Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/laser-eye-surgery-consent-form.png)

### Laser Eye Surgery Consent Form

A comprehensive medical consent form for laser vision correction procedures including LASIK and PRK. Documents patient understanding of risks, benefits, vision correction expectations, and post-operative care requirements.](/templates/laser-eye-surgery-consent-form/)
[![Medical Spa Injectable Treatment Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/medical-spa-injectable-treatment-consent-form.png)

### Medical Spa Injectable Treatment Consent Form

A comprehensive consent form for medical spa injectable treatments including Botox and dermal fillers, covering treatment risks, aftercare instructions, photo authorization, and HIPAA compliance.](/templates/medical-spa-injectable-treatment-consent-form/)
[![Neurological Testing Consent Form - EMG/NCV](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/neurological-testing-consent-form-emgncv.png)

### Neurological Testing Consent Form - EMG/NCV

A comprehensive consent form for electromyography (EMG) and nerve conduction velocity (NCV) testing, covering procedure details, risks, patient rights, and HIPAA authorization.](/templates/neurological-testing-consent-form-emgncv/)
[![Plastic Surgery Revision Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/plastic-surgery-revision-consent-form.png)

### Plastic Surgery Revision Consent Form

Comprehensive consent form for plastic surgery revision procedures, capturing previous procedure details, realistic expectations, costs, and healing timelines to ensure informed patient consent.](/templates/plastic-surgery-revision-consent-form/)
[![Wound Care Treatment Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/wound-care-treatment-consent-form.png)

### Wound Care Treatment Consent Form

A comprehensive consent form for wound care treatment including debridement procedures, infection risk disclosure, dressing protocols, and hyperbaric oxygen therapy authorization.](/templates/wound-care-treatment-consent-form/)
[![Atrial Fibrillation Ablation Procedure Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/atrial-fibrillation-ablation-procedure-consent-form.png)

### Atrial Fibrillation Ablation Procedure Consent Form

A comprehensive medical consent form for patients undergoing cardiac ablation procedures to treat atrial fibrillation, including detailed information about risks, benefits, and success rates.](/templates/atrial-fibrillation-ablation-procedure-consent-form/)
[![Blood Transfusion Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/blood-transfusion-consent-form.png)

### Blood Transfusion Consent Form

A comprehensive medical consent form for blood transfusion procedures, covering infectious disease risks, religious accommodations, and alternative treatment options.](/templates/blood-transfusion-consent-form/)
[![Cardiac Catheterization Consent Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/cardiac-catheterization-consent-form.png)

### Cardiac Catheterization Consent Form

Comprehensive consent form for cardiac catheterization procedures including angiography, contrast dye screening, stent placement authorization, and detailed risk acknowledgment.](/templates/cardiac-catheterization-consent-form/)