CONFIDENTIAL DIABETES SURVEY

INSTRUCTIONS: We are conducting a national survey among people who have been diagnosed with diabetes or are caring for someone with diabetes. Your feedback will help to educate other people with diabetes and you will remain anonymous unless you choose to identify yourself at the end.

Please start the survey below...you can save your answers at any point and come back to finish later.

Thank you for your help!
Signature Research Group

 
 
 
 
What type of diabetes does the patient have?
 
Type 1
 
Type 2
 
Don't Know/ Not Sure
 
Doesn't apply / No one has diabetes
 
     |  
3%