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* 1. Please fill out the below.

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* 5. We are conducting a day of focus groups to discuss the creation of an online tool that could help you manage your Diabetes, and live a healthier life. Are you comfortable participating in a group discussion with several other individuals who also suffer from Diabetes?

* 6. On the same day we will also conduct one-one-one sessions for the same online tool. If chosen, would you be interested in attending a solo interview?

* 7. The focus groups will be held on June 23rd in San Francisco near downtown/SoMa and June 30th in New York City near Union Square. Are you available for approximately 3 hours on that day?