Health Promotion CouncilA PHMC Affiliate

Trainee Portal Sign in

Register for Technical Assistance

Registering is the first step in receiving technical assistance.  After we verify your form, you will receive a username and password within a few days.  As a registered participant, you will have access to the catalog of resources and trainings PA CCI has collected, as well as, be eligible for live and responsive techincal assistance and a scholarship for DSME certification.

Multipage

DSME Certification Scholarship Application

If you are interested in receiving financial assistance to cover the cost of becoming an accredited or recognized Diabetes Self-Management Education (DSME) site through American Diabetes Association (ADA) or American Association of Diabetes Educators (AADE), please complete the following scholarship application. Financial assistance is limited to 30 sites in the first year, but all interested sites can receive free technical assistance in becoming an accredited or recognized DSME site. This application asks questions about your organization overall, your organization’s DSME program, staff credentials, and the population you serve.

Organizations operating in areas of geographic need and/or serving high-need populations will be given priority for scholarships. Because of this, you will need to list all of the ZIP codes in which you provide DSME services as part of the application.

Organizational need (financial, capacity, etc.) will also be taken into consideration. We may be contacting you for more information about your organization in order to make the final decision of the 30 scholarships awarded.

Organization Information

Diabetes Self-Managment Education Program Information

Do you have documentation demonstrating that your organization supports DSME as a distinct service provided by the organization? This could be an organizational chart, letter of support, or job descriptions of staff that coordinate and/or manage DSME programs.
Please list all ZIP codes in which your site has offered diabetes education programs over the past six months. This information is needed to process your scholarship application in order to determine whether your organization is providing services in areas with high need. Note: Please list program location ZIP codes ONLY; it is not necessary to list patients' home ZIP codes.
Financial assistance is limited to 30 sites in the first year, but all interested sites can receive free technical assistance in becoming an accredited or recognized DSME site. Organizations operating in areas of geographic need and/or serving high-needs population will be given priority for scholarships. Organizational needs (financial, capacity, etc.) will also be taken into consideration. We may be contacting you for more information about your organization in order to make the final decision of the 30 scholarships awarded.