Contact 1 — U Got This!

Interested In Joining?

Ready to make a positive impact on your health?

Please answer the following questions to determine your eligibility and confirm you are interested. A representative from The National Center for Urban Solutions will reach out to you regarding your response.

Thank you!

Are you over the age of 18?

Are you Medicaid eligible?

Are you insulin dependent?

Do you currently use a Continuous Glucose Monitor (CGM)*?

*Or have you used one in the last 90 days?

Name

First Name

Last Name

Phone

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Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Ready to Enroll?

Do you meet all the requirements and feel ready to officially enroll? Please complete the enrollment form to begin your journey in this life changing program. Welcome!

Enrollment Form