If you have multiple children with diabetes please fill this out for the youngest child first. As each child is different one survey response cannot capture information for multiple children therefore, if you have multiple children with diabetes, upon completing the survey please close all browser windows then re-click the link to complete an additional survey for each child with diabetes. Thank you for your assistance in helping us better understand your needs.

* 1. How old is your child with diabetes?

* 2. Does your child have Type 1 or Type 2?

* 3. Please indicate if your child uses an insulin pump and if so which.