PEBB 2017 Food Drive Challenge Survey

Your plan will donate a dollar for you to the Governor's State Employees Food Drive when you meet the PEBB 2017 Food Drive Challenge:

1.     Take an online, prediabetes screening test – less than 10 questions.

2.     Use your plan’s diabetes prevention resources if you're at risk.

3.     Complete this survey.

Your plan will make the donation only after you complete this survey.

Question Title

* 1. Please check the name of your health plan.

	My Health Plan
AllCare PEBB	AllCare PEBB My Health Plan
Kaiser Permanente (HMO & Deductible)	Kaiser Permanente (HMO & Deductible) My Health Plan
Moda (Summit & Synergy)	Moda (Summit & Synergy) My Health Plan
Providence (Choice & PEBB Statewide)	Providence (Choice & PEBB Statewide) My Health Plan

Question Title

* 2. I took the online prediabetes test.

Yes

Question Title

* 3. I know the resources my plan offers to prevent diabetes.

Yes

Question Title

* 4. My email address is

Email Address