Wisconsin Dietetic Association's Type 2 Diabetes Outcomes Study
Additional Forms Utilized by Participating Dietitians

The following procedural forms allowed participating dietitians to obtain informed consent, track enrolled subjects, and recruit support from referring physicians. To protect the privacy of the subjects, these forms were not submitted with data collection forms, but remained on file at the health care facility.

To adapt these forms for your own use:

• Modify the highlighted areas to match your institution and study description.

• Please credit the source: "Wisconsin Dietetic Association’s Type 2 Diabetes Outcomes Study [Name of Form]. Available at http://www.eatrightwisc.org/omi/omi.htm. Accessed [your date of access]."

Forms:

1. Patient Information and Informed Consent Form (Links to a PDF file. Adobe Reader is necessary to open this document. Reader can be downloaded free of charge from the Adobe website).

2. Patient Tracking Form (PDF File)

3. Letter to Referring Physician (PDF File)