MARKET RESEARCH – Project Diabetes Patients

We are looking for people who have been diagnosed with Diabetes to take part in an interview for 1 hour in London.

LOCATION:		London WC1
DATE:		Dates vary from Tuesday 12th July – Thursday 14th July 2016
INCENTIVE:		£50.00
TIME:		Various times available during the day/evening

Please answer the questions below.

Name:

Telephone number:

Postcode:

Age:

Occupation:

Who do you live with at home?

Which type of Diabetes have you been diagnosed with?

Type 1
Type 2

Which of the following types of medications do you take for your diabetes?

Oral tablet
Insulin injections
Non Insulin injections
Diet/exercise controlled
Insulin pump

Have you ever used injections for your diabetes during the last 2 years? Yes/No?

Please tell us the names of all medications that you take for your diabetes.

Which make and model of mobile phone do you own and use?

Please forward this on to anyone you know who may be interested.

Unfortunately, it is impossible to reply to all emails or phone messages. We receive lots of responses to researches that are emailed out. You will be contacted by phone if your application is successful. However, we apologise if you do not hear from us, but please keep trying for future projects that are sent out.

We look forward to hearing from you.

Kind regards,

Daliah Salem
trend MARKET RESEARCH LTD