SurveyMonkey Powered Online Survey

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Your clinical expertise matters. Complete this 2-minute screening survey to see if you qualify for a paid Roche Diabetes Co-Creation Forum on Type 2 diabetes care.

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1. First and Last Name (Required.)

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2. Email address (Required.)

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3. Phone number

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4. What is your current medical or professional role? (Required.)

Nurse Practitioner (NP)

Pharmacist (Independent Owner/Associate)

Pharmacist (Corporate/Staff/Manager)

Certified Diabetes Educator (CDE) / DEC Nurse

Physician Assistant (PA)

Pharmacy Lab Technicians

Other (please specify)

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5. In which province or territory do you currently practice?

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6. Which of the following best describes your primary practice setting?

Independent Community Pharmacy (e.g., Jean Coutu, Familiprix, Guardian, Remedy'sRx, local independent)

National / Regional Corporate Chain Pharmacy (e.g., Shoppers Drug Mart, Rexall, London Drugs, Walmart)

Hospital or Community Diabetes Education Centre (DEC)

Primary Care Clinic / Family Health Team / Primary Care Network (PCN)

Independent Clinical Practice (e.g., Autonomous Nurse Practitioner or PA clinic)

Other practice setting (Please specify):

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7. What is the biggest operational barrier you face when recommending traditional Blood Glucose Monitors (BGM) to patients living with non-insulin Type 2 diabetes?

Managing tech-support and digital onboarding friction in a high-volume, fast-paced retail environment

Navigating strict provincial public strip limitations (e.g., 200 strip caps or 50 strip caps) while trying to get actionable data

Finding a standardized, easy-to-read data report (like a PDF summary) to quickly assess patient glucose variability patterns during brief reviews

Other (please specify)

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8. Does your clinic or pharmacy routinely serve patients utilizing the federal Non-Insured Health Benefits (NIHB) program?

Yes

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* 1. First and Last Name (Required.)

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* 2. Email address (Required.)

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* 3. Phone number

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* 4. What is your current medical or professional role? (Required.)

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* 5. In which province or territory do you currently practice?

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* 6. Which of the following best describes your primary practice setting?

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* 7. What is the biggest operational barrier you face when recommending traditional Blood Glucose Monitors (BGM) to patients living with non-insulin Type 2 diabetes?

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* 8. Does your clinic or pharmacy routinely serve patients utilizing the federal Non-Insured Health Benefits (NIHB) program?

1. First and Last Name (Required.)

2. Email address (Required.)

3. Phone number

4. What is your current medical or professional role? (Required.)

5. In which province or territory do you currently practice?

6. Which of the following best describes your primary practice setting?

7. What is the biggest operational barrier you face when recommending traditional Blood Glucose Monitors (BGM) to patients living with non-insulin Type 2 diabetes?

8. Does your clinic or pharmacy routinely serve patients utilizing the federal Non-Insured Health Benefits (NIHB) program?