MARKET RESEARCH – Project Diabetes Patients July

We are looking for people who have been diagnosed with Diabetes to take part in an interview for 45 minutes in London

Please answer the questions below.

Name:

Telephone number:

Home Postcode:

Age:

Ethnicity:

Occupation:

Job Title:

Industry:

Working status i.e. full time, part time, etc

Occupation and job title of chief income earner in the household:

Who do you live with in your household?

Have you been diagnosed with?

• Type 1 Diabetes
• Type 2 Diabetes

Do you use a pre filled insulin pen? Yes/No?

Please tell us the name of the insulin pen that you use.

How long have you been using a pre filled insulin for?

Which of the following types of insulin are you using?

• Basal only (long acting)
• Bolus only (fast acting)
• Both basal and bolus

Are you colour blind? Yes/No?

If you are colour blind, which specific colours do you have difficulty seeing?

Which make and model of mobile phone do you 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