Refer a patient to Blue Circle Health
Let’s work together. Fill out this form to connect your patient to free type 1 diabetes care and support.
Now available in 17 states and Washington, D.C.: Alabama, Connecticut, Delaware, Florida, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Mississippi, Missouri, New Hampshire, Ohio, Pennsylvania, Vermont, Virginia, and Washington D.C.
Eligibility Requirements
To sign up for Blue Circle Health, a patient must meet the following requirements:
- Be diagnosed with type 1 diabetes
- Be 18 years or older
- Live in Alabama, Connecticut, Delaware, Florida, Iowa, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Mississippi, Missouri, New Hampshire, Ohio, Pennsylvania, Vermont, Virginia, and Washington D.C.
- Speak English and/or Spanish
- Have access to the internet and a smartphone or computer to do video calls with the care team
- Have a primary care provider and/or endocrinologist, or are willing to be connected to one
- Are not currently pregnant
What Happens Next?
After you submit the form, our Clinical Enrollment Specialist will contact your patient within 1–2 business days to walk them through the enrollment process.
We’ll keep you in the loop by sending clinical notes to the referring provider listed on the form. For any questions or if you’d like to send accompanying medical records, email us at referrals@bluecirclehealth.org, call us at 888-404-4813, or fax records to us at 888-675-4061.
Let's Connect
Our Community Engagement Team would love to connect with you! Email them at connect@bluecirclehealth.org to:
- Join our monthly clinical partnership meetings for referring providers and partners
- Request digital or physical flyers and material for your patients
- Set up a time for you and your team to learn more about the Blue Circle Health program and how we can work with your organization
What do others say about our program?
