People with diabetes and their families can benefit enormously by becoming member of Asian DiabetesCare Berhad. Learning about diabetes and how to manage it is vital especially to people who newly diagnosed.

Membership provides you with access to the latest research and resources and offers people with diabetes and their families' benefit.

Your subscription fee also goes towards supporting research and services to people with diabetes.

We are looking for members to support us to help and educate, diabetic patient about awareness of diabetic and its consequences.

Join DiabetesCare Berhad to fight diabetes together.

Members Application Form
Please Complete All The Details

Name :		Dr. Encik/Mr. Cik/Ms. Puan/Mrs.
IC :		eg. 810127-06-5245
Age :		80 79 78 77 76 75 74 73 72 71 70 69 68 67 66 65 64 63 62 61 60 59 58 57 56 55 54 53 52 51 50 49 48 47 46 45 44 43 42 41 40 39 38 37 36 35 34 33 32 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 09 08 07 06 05 04 03 02 01 01
Address :
Telephone :
Fax :
Email :
Profession :
Membership :		Ordinary - RM 15 per year
		Commercial - RM 100 per year
		Diabetic (Mengidap), Duration Non-Diabetic