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JDRF Survey
1.
How do you rate awareness of type 1 diabetes?
High awareness
Low awareness
No awareness
2.
At what age were you or your child diagnosed with type 1 diabetes?
0-10
10-20
20-30
40+
3.
Do you ever feel society discriminates against you or your child because of the condition?
Yes
No
4.
Were you or your child ever bullied at school in any way as a result of having type 1?
Yes
No
5.
Have you or your child ever experienced discrimination at school or in the workplace because of type 1?
Yes
No
6.
Do you feel there is a perception in society that type 1 is a result of poor diet and/or lifestyle?
Yes
No
7.
Have you or your child ever felt depressed as a result of your condition?
Yes
No
8.
Do you feel you or your child missed out on part of your/their childhood because of your/their condition?
Yes
No
9.
How many days on average did/do you or your child miss from school or work each year as result of your/their condition?
School
Work
0 – 5 days
School
Work
5 – 10 days
School
Work
10 – 20 days
School
Work
20 days+
School
Work
I cannot work/my child cannot go to school because of my/their condition
School
Work
10.
Are you worried about the financial impact of having type 1?
Yes
No
11.
Are you worried about having to give up work or go part-time as a result of managing your own or a child’s type 1?
Yes
No
12.
Has your condition caused you or your child to give up the things you enjoy?
Yes
No
If so, what?
13.
Is there more than one person in your family with type 1 diabetes?
Yes
No
N/A
