Blood Sugar Management Questionaire 
Email *
What gender are you? *
What is your age?
How long has it been since you have been diagnosed with a blood sugar issue, diabetes or pre-diabetes?
What type of blood sugar issue do you have?
Clear selection
What is your current method for monitoring your blood sugar levels?  
Clear selection
What is your target blood sugar range and how often are you within that range? (mostly, sometimes, rarely, never)
What  medications, if any, are you using to manage your blood sugar?
Do you follow a specific diet plan? If so, what is it?
How days in a week do you engage in physical activity, on average?
What are your biggest challenges in managing your blood sugar?
What lifestyle changes have you attempted to help manage your blood sugar?
What is your contact information? (Name, Email, Mobile Number)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report