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