Home blood glucose testing habits


Please use this form to have your home blood glucose testing information included in the survey. Chose the testing category that best describes your testing habits.

* Indicates a required field. Your e-mail address is required so I can contact you with questions. Your e-mail will not appear on the page. If you omit required information or if your e-mail is not valid, an error message will pop up and you won't be able to send the information until valid information is entered.

After you hit the 'send info' button, your information will be sent to me and I will add the information to the page. I will update the survey results periodically.

After you submit your information you will be returned to the home bg testing main page.
Your Name: *
Your E-Mail:*
 (so I can contact you)
Species: * Cat Dog Hamster, Guinea Pig
How long after diagnosis
did you begin testing?
Testing Habits* Never
Occasionally
      (if I think there is a problem)
Regularly
      (monthly curve, weekly test for low bgs, etc)
Daily
      (pre-injection bg test or daily test for low bg)
Several times daily
Comments:

 

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Updated December 2001
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