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Surveys
2014
December
H
Heatth outcome
Heatth outcome
0%
Exit Survey
What is your age?
15-24
25-34
35-44
45-54
55-64
65+
Race/Ethnicity?
Hispanic or Latino
American Indian or Alaska Native
Asian
African American
Native Hawaiian or Other Pacific Islander
White
Other
Do you have diabetes?
Weekly
Monthly
Quarterly
Annually
Other
Do you have the information, support & tools you need to manage diabetes?
Weekly
Monthly
Quarterly
Annually
Other
Have you ever had diabetes education?
Completely disagree
Somewhat disagree
Slightly disagree
Neutral, Slightly agree
Somewhat agree
Completely agree
Would you consider going to diabetes education classes?
Completely disagree
Somewhat disagree
Neutral
Somewhat agree
Completely agree
Other
What would keep you from going to diabetes education classes?
Weekly
Monthly
Quarterly
Annually
Other
Do you think diabetes education classes should be a one time class or should you attend refreshers??
1
2
3
4
5
6
7
What do you think would be needed in a diabetes education program to make it ideal for you??
A very great deal
A great deal
Quite a bit
Moderately
Somewhat
A little bit
A tiny bit
About the same
Other
Where do you get answers to your questions about diabetes?
Not at all satisfied
Slightly satisfied
Moderately satisfied
Very satisfied
Completely satisfied
Other
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