Diabetes Outreach Network
Independent Study Module Series

Instructions:

1. Read the Purpose & Objectives, Introduction (if applicable), Case Study (if applicable), and all information associated with the Module. Refer to the appendices as needed.

2. Print out the Registration Application/Post Test and the Participant Evaluation form associated with the module. The forms are in Acrobat® Reader format. If you have trouble printing the forms go to www.adobe.com/acrobat and download Acrobat® Reader.

3. Fill out all information requested on the Registration Application, take the Post Test and fill out the Participant Evaluation form. Please use your driver's license or RD or nursing license number when registering. Failure to do so may result in delays or loss of credit due to problems encountered by the computer database.

4. Contact hours are free if you live or work in Michigan. Mail your Registration Application/Post Test and Participant Evaluation to your local DON office. It is important to choose the correct DON when registering. If you are unsure of what DON you reside in, please check here first.

Otherwise, the cost for the 2 contact hours is $20 (nonrefundable). Make your check or money order payable to UPDON. Credit cards are not accepted. DO NOT SEND CASH. Mail the completed Registration Application/Post Test and Participant Evaluation along with your check or money order to: UPDON; 220 West Washington Street, Suite 420, Marquette, MI 49855

5. Upon successful completion of the module, you will be sent a certificate for 2 contact hours of continuing education. Successful completion is defined as:

• Achieving 70% (14 correct out of 20 questions) or better on the Post Test .
• Sending a completed Participant Evaluation form along with the Post Test.
• Sending your payment, if applicable, along with the Post Test.

6. Your certificate and any other pertinent comments will be sent to the home address provided on the Registration Application/Post Test form.

7. If you have any questions that cannot be answered by your agency’s supervisor, contact your local MDON office or if you are out-of-state contact UPDON at (906) 228-9203 or e-mail them.

Note: If you scored less than 70% on the Post Test, you will be notified and allowed a second opportunity to review the module and resubmit a new completed Registration Application/Post Test form. No fee will be collected for this second opportunity.