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Jump Start Diabetes
Getting to Know You
Thank you for participating in our survey. Your feedback is important.
1.
I am 18 years of age or older and have type 2 diabetes
Yes
No
2.
I understand that this survey is voluntary. This information collected will be used in a study. My information is anonymous. By answering yes, I agree to participate and understand I can withdraw at any time during the survey process.
Yes
No