Fear of Night-time Hypoglycaemia Demographics General Information Question Title * 1. Demographic Details Name: Address 1: Address 2: City/Town: State:* * Postal Code: Country:* * Email Address: Phone Number: Question Title * 2. T1D Date of birth (dd/mm/yyyy) Question Title * 3. Date of Diagnosis (dd/mm/yyyy) Question Title * 4. I am A parent or carer of a child with type 1 diabetes Someone with type 1 diabetes Neither The information collected in this survey will used in in accordance with our privacy statement, which can be found here: Privacy Statement Next
