Diabetes Survey

FREE HbA1C TEST FOR ALL DIABETICS WHO COMPLETE THIS SURVEY (while supplies last)

You can play a role in helping to advance treatment options for diabetes by participating in clinical research trials. This 5-minute survey will help us to better select study opportunities that could potentially help you and your loved ones.

The more information we have about our diabetic population, the more progress we can make in finding better options for diabetics.

This is a voluntary survey for diabetics interested in research participation. The complimentary HbA1C test is being offered at the Dallas, TX location only (635 @ Webb Chapel). We will call to verify the information you submit on this form is accurate and to schedule your no cost HbA1C test. We do not share or sell your information to anyone, unless required by law. To read more about our privacy policy, click the following link: http://www.researchacrossamerica.com/PrivacyPolicy.htm

If you would prefer to complete this survey by phone, please feel free to contact us at 972/4DOCTOR (extension 4). 

Powered by SurveyMonkey
Check out our sample surveys and create your own now!