How familiar are you with the American Diabetes Association?

Were you aware that the ADA offers programs throughout the Greater Rochester region?

Please select the description that best describes your knowledge or relationship with the ADA in Rochester. (Please select all that apply)

Has diabetes touched your life? (Please select all that apply)

What do you believe to be the causes of diabetes? (check all that apply)

When you read through the statements below, please check the ones that you think make the most sense to you.

What do you believe people with diabetes can do to help their conditions? (please check all that apply)

What inspires you when it comes to health? (please check all that apply)

How important is the work of the ADA office here in Rochester, compared to other health organizations locally?

Please complete this sentence: The American Diabetes Association/Rochester Division is the clear leader in providing our community with (check all that apply):

If the ADA Rochester office were to disappear tomorrow, where would you turn to for the services it provides?

If you had to use one sentence to describe the ADA Rochester Division to someone new in the area, what would you say?

Where do you look for information and health care options in Rochester? Please check all that apply.

If you had to choose one way to get information about health, what would you choose?

How important is it to you to participate in events that tie-in to health condition awareness?

How do you support groups who are working to raise awareness about medical conditions, such as diabetes?

Please indicate your age

To which racial or ethnic group(s) do you most identify?

What city/town do you live in?

What is your annual household income? (Remember, your answers are completely anonymous.)

If there is anything else you’d like to tell us about your experience with the ADA in Rochester (a compliment, a suggestion, anything) please add it below. Again, your responses are completely anonymous.