Get Diabetes Questionnaire

Completing the Diabetes Questionnaire online is an essential step for managing your health. This guide provides clear instructions to ensure you fill out the form accurately and efficiently, addressing each component as you progress.

Follow the steps to complete the Diabetes Questionnaire online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering your age at the time you were diagnosed with diabetes in the appropriate field.
3. If you have ever been hospitalized for uncontrolled blood sugars, indicate 'Yes' or 'No' and provide the date if applicable.
4. Respond to questions about experiencing low blood sugar reactions, noting how often these occur if applicable.
5. Indicate whether you get regular eye exams. If 'Yes', provide the date of your last exam and the name of your eye doctor.
6. Answer questions regarding diabetic eye diseases and eye surgery with 'Yes' or 'No' as appropriate.
7. Indicate whether you have ever been told you have protein in your urine.
8. Respond to whether you have been told you have kidney disease related to your diabetes.
9. Answer questions regarding foot problems, mentioning any regular foot doctor visits and their details.
10. Indicate whether you wear a medical alert bracelet for diabetes.
11. Respond to whether you see a dentist regularly and provide the date of your last visit.
12. Indicate if you have attended Diabetes Education classes, providing the date and location if applicable.
13. Mention if you check your blood sugar at home, including frequency and the name of your glucose meter.
14. Provide examples of typical meals including breakfast, lunch, and dinner.
15. If you snack between meals, describe the types of foods you typically consume.
16. After completing all fields, review your responses for accuracy.
17. Once satisfied with your form, proceed to save changes, download, print, or share the completed questionnaire.

Start completing your Diabetes Questionnaire online today!