Professionals - Let's change diabetes together!

Do some of your diabetes patients need help paying for their medications or improving their day-to-day management of the disease? If so, Iowa Diabetes in West Des Moines may be an option for them.

Iowa Diabetes is led by Dr. Anuj Bhargava, an endocrinologist practicing in the Des Moines area since 2002. Our team offers patients in Central Iowa the opportunity to:

Receive free meds and care by participating in research studies
Receive specialized diabetes care
Use the most comprehensive diabetes portal
Access in-depth diabetes education
Find a supportive diabetes community

To refer a patient to Iowa Diabetes, please complete the form below.

Referring Doctor/Provider Information

Doctor/Provider Name *

Please enter the doctor/provider's last name.

Phone *

Please enter a valid phone number.

Fax *

Please enter a valid fax number.

Referring patient to: *

Iowa Diabetes Research

Iowa Diabetes Care

Either

Please select which you are referring your patient to. Click either if unsure.

Patient Information

Last Name *

Please enter patient's last name.

First Name *

Please enter patient's first name.

Date of Birth *

Your date of birth is required.

Phone *

Please enter a valid phone number.

Please enter a valid email address.

Type of Diabetes

Year of Diagnosis

Most Recent A1C (%)

Please enter your most recent A1C in range from 4 to 20.

Date Done

Comments

If possible, please fax medical history, med list, and last lab results to us at 515-329-6799.

Please note: The safety of our patients is our #1 priority. You can be assured that our site has the highest level of security and encryption.

Extra Support For Your Diabetes Patients

Referring Doctor/Provider Information

Patient Information

Thank you so much for your referral. We will be contacting your patient soon!

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