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Please answer a few questions to help us understand how best to serve you. You are not required to answer, but we hope that you will. This information will be collated and may be published on our website periodically, or may be used for publication, but we will use composite data only. We do not maintain any individual data from these items. If you ask another question at a later time, please fill this out each time.

From whom are you asking this question?

The age of person in question is:

The Person in question has:

The Person in question has had diabetes for:

The treatment plan of the person in question is:

What kind of insurance coverage does the person have?

Medical care about blood sugar problems is provided by:

You are asking this question because:

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Where do you live?

Please tell us where you live (city, state, and country). This information can help us answer your question.

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To preserve condentiality, we strongly recommend that you do not include in your question any information that identies you, your child or any other individual. Please note: Questions that are published may be edited for space and clarity.

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