A Short Survey for the Analysis of Type 1 Diabetes Development Caurses
Exit this survey
1. Default Section
1
. What form of Diabetes do you have?
What form of Diabetes do you have?
Type 1
Type 2
2
. You have Diabetes Type 1. Do you have any relatives by blood with Diabetes Type 1?
You have Diabetes Type 1. Do you have any relatives by blood with Diabetes Type 1?
Yes
No
3
. How old were you when Diabetes Type 1 developed?
How old were you when Diabetes Type 1 developed?
0-10
10-20
20-30
30-40
4
. Have you ever had following virus disease?
Have you ever had following virus disease?
Epidemic parotiditis (mumps)
Rubella
Coxsackie virus
Cytomegalic inclusion disease
Measles
None
Other
Other (please specify)
Powered by
SurveyMonkey
Check out our
sample surveys
and create your own now!
Javascript is required for this site to function, please enable.