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PlanIt Research Questionnaire
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PlanIt Research Questionnaire
Admin_PIR
2023-09-23T18:39:36+00:00
Full Name
*
Email Address
*
Phone Number
*
1. Do you have diabetes type 2?
*
Yes
No
2. How many years have you had diabetes?
*
3. Do you have either of the following?
Kidney Disease
Heart Disease/Stroke
None
4. List all medications taken for diabetes:
*
Submit
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