US DIABETIC SURVEY

Hi,
Am i speaking to Mr/Ms_________, A very good day to you Mam/sir.How are you doing today?.

My name is ________and i’m calling you from Free Diabetic Testing Provider/Better of Healthy/Global diabetic Research centre.We are going to send out your free Diabetic upgraded Testing Meter,The reason for my call is to confirmed weather you are qualify or not for free /we are sending to the right place .It will take hardly 2 Minutes of your time .Is it okay with you.

Mam/Sir I’m not asking you to buy anything,this is just a very quick call to check you are qualified or not for your free upgraded testing Meter.You don’t need to pay any single penny,i’ll just confirmed only few questions.. Is it Okay.

I Agree

Customer Information

First Name :

Last Name :

Address 1 :

Address 2 :

City :

State :

Zip :

* Phone :

Just to confirm I’m speaking to the right person, I have your First Name is___ and your last name is___?

And you’re currently diabetic or (having blood sugar). Correct?

Yes

In which age bracket do you fall above 65 or below 65?

Above

Below

Your date of birth is____right? or (Please can you provide me your D.O.B?)

Currently you’re testing your blood sugar at home right?

Yes

Okay great ,Please can you confirm the name of your Primary Health Insurance Carrier,is it ?

Primary Insurance Name

Govt or private Insurance?

Gov't

Private