What type of Diabetes do you have? Please select Type 1 Type 2 Gestational Pre-diabetes
Which of the following methods do you use to manage your diabetes? Please select Insulin Syringe Insulin Pump Insulin Pen Oral Medication (Pills) Other None
How often do you test your blood glucose levels? Please select 1 or 2 times per day 3 or 4 times per day More than 4 times per day I do not test my blood for glucose
What Type of Insurance or reimbursement do you have for your test strips? Please select Private Insurance or Managed Care Plan Medicare Medicare plus other coverage Medicaid No Coverage Other