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Get Ymca Intakes

Rogram?* Yes No STEP ONE: PARTICIPANT DETAILS Race/Ethnicity: American Indian or Alaska Native Asian Native Hawaiian or Other Pacific Islander Black or African American Hispanic/Latino of any race White First name* Middle name Last name* Gender* Date of birth* STEP TWO: BMI & QUALIFICATION CRITERIA Height (ft)* Height (in)* Weight (lbs)* self-reported Meets Blood Value/Diagnosis Qualification: A1c: (must be 5.7%-6.4%) Fasting Plasma Glucose: (must be 100-125 mg/dL) 2-h.

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