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		Request a CWD Welcome Kit	Jump to a new section --[ Getting Around ]-- Home Page What's New Guide to CWD Help with Error Messages Index Privacy Policy Search Site Map --[ People ]-- Family Support Network Adults with Diabetes Care Photos Chat Rooms Conferences cwdMail Spam Protected Email IDYA Teen Advocates Kids with Diabetes Parents Parent Humor Scholarships and Financial Aid Grads Grandparents Humorous Tidbits Jobs Mailing Lists CWD Forums Poetry and Art Polls Quilt for Life Surveys --[ Clinic ]-- Ask the Diabetes Team Alternate Site Testing Alternative Treatments Care Suggestions CWD Español Diabetes Basics Diabetes at School 504 Plans Diabetes Camps Diabetes Dictionary Insulin Pumps Nutrition Podcasts Presentations Products Product Marketplace Sports Studies Warning Signs --[ Sources ]-- News and Information Diabetes Advocacy Links to Other Web Sites Press Releases Regional Information Services Support Groups --[ Feedback ]-- About CWD Get CWD Products Advertise Awards Contribute Your Experiences Disclaimer Letters to the Editor Logos and Linking Share our Brochures

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Mail the CWD Welcome Kit To Coupon Code: -‡ First Name: ‡ Last Name: ‡ Address: ‡   City: ‡ State: Select … Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Armed Forces Americas Armed Forces Europe Armed Forces Pacific Federated States of Micronesia Marshall Islands Northern Mariana Islands Palau Virgin Islands ‡ ZIP: ‡ Country: United States Phone: ‡ Email: ‡   Who has diabetes? Select … My child My grandchild I do My spouse My mother or father A relative A friend I am a health care provider Other ‡     I would like to receive more information about: Blood glucose monitoring from LifeScan Insulin pump therapy from Animas Children with Diabetes conferences   About the Person Who Has Diabetes First Name: ‡ Last Name: ‡ Gender: Select … Female Male I'd rather not say ‡   Birthdate: Month‡ Day‡ Year‡ January February March April May June July August September October November December   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910   Type of Diabetes: Select … Type 1 Type 2 Gestational Other I don't know ‡   Date of Diagnosis: Month‡ Day‡ Year‡ January February March April May June July August September October November December   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31   2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910   What kind of diabetes treatment is used? Select … Insulin Pump Insulin Injections Pills Diet and Exercise Other Not Specified I'd rather not say ‡   How often do you check blood sugars each day? Select … Never 1 Time a Day 2 Times a Day 3 Times a Day 4 Times a Day 5 Times a Day 6 Times a Day 7 Times a Day 8 Times a Day 9 Times a Day 10+ Times a Day ‡   My family receives Medicare or Medicaid    Do you already have a blood glucose monitor? Select … Yes No   If yes, how did you get the monitor? Select … From our diabetes team From a retail pharmacy From a mail order pharmacy Some other way   What is the brand (name) of the blood glucose meter? Select … LifeScan OneTouch Ultra LifeScan OneTouch Ultra2 LifeScan OneTouch UltraSmart Other LifeScan meter Abbott Diabetes Care FreeStyle Flash Abbott Diabetes Care FreeStyle Abbott Diabetes Care Precision Xtra Other Abbott Diabetes Care meter Ascensia Breeze Ascensia Contour Ascensia DEX2 Ascensia Elite or EliteXL BD Logic Medtronic MiniMed Paradigm Link Roche Diagnostics Accu-Chek Active Roche Diagnostics Accu-Chek Advantage Roche Diagnostics Accu-Chek Aviva Roche Diagnostics Accu-Chek Compact Roche Diagnostics Accu-Chek Compact Plus Roche Diagnostics Accu-Chek Complete Other Roche Diagnostics meter Store brand meter Other I don't know   What was the most important factor in the selection of this meter? Select … Cost (I pay full price for my own medical supplies) Cost (Insurance co-pay was the lowest) Speed of testing Small volume of blood Alternate site testing capability Data management capabilities Other feature

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The CWD Welcome Kit is supported through the generosity of LifeScan and Animas.

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			Jump to a new section --[ Getting Around ]-- Home Page What's New Guide to CWD Help with Error Messages Index Privacy Policy Search Site Map --[ People ]-- Family Support Network Adults with Diabetes Care Photos Chat Rooms Conferences cwdMail Spam Protected Email IDYA Teen Advocates Kids with Diabetes Parents Parent Humor Scholarships and Financial Aid Grads Grandparents Humorous Tidbits Jobs Mailing Lists CWD Forums Poetry and Art Polls Quilt for Life Surveys --[ Clinic ]-- Ask the Diabetes Team Alternate Site Testing Alternative Treatments Care Suggestions CWD Español Diabetes Basics Diabetes at School 504 Plans Diabetes Camps Diabetes Dictionary Insulin Pumps Nutrition Podcasts Presentations Products Product Marketplace Sports Studies Warning Signs --[ Sources ]-- News and Information Diabetes Advocacy Links to Other Web Sites Press Releases Regional Information Services Support Groups --[ Feedback ]-- About CWD Get CWD Products Advertise Awards Contribute Your Experiences Disclaimer Letters to the Editor Logos and Linking Share our Brochures

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Last Updated: Fri Jun 27 10:40:55 EDT 2008
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