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INFO@APG-HEALTH.COM

Diabetic Foot Trial-Pre-Enrolllment

First name*

Last name*

Birthday*

Month

Day

Year

Email*

Phone*

Inclusion Criteria

Do you have Diabetes*

Date first noticed foot ulcer*

Month

Day

Year

Is your wound located on the foot*

Is your wound at least HALF the diameter (width) of a dime?*

Do you have an amputation on the affected foot.*

Have you had a HbA1c greater than 12% in the last 3 months

The potential subject must agree to attend the weekly study visits required by the protocol.

The potential subject must be willing and able to participate in the informed consent process.

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© 2023 by APG

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Headquarters

530 Forest Parkway

Forest Park, GA 30297

Mail: info@apg-health.com

Tel: 770.545.2052

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