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* 1. Please choose your Community Health Centre location

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* 2. Age

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* 3. Gender

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* 4. How long have you been with West Toronto Diabetes Education Program?

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* 5. Is English your preferred language ?

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* 6. My appointments are accessible (easy to get to).

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* 7. Transportation is a problem for me.

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* 8. If needed, a bus ticket (TTC or MIT) has been offered to me

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* 9. When the time of an appointment does not work for me, another time is offered in a timely manner.

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* 10. I am offered the option to choose an onsite or virtual (phone or video) appointment according to my preference.

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* 11. My preferred appointment method is virtual (phone or video).

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* 12. I use social media (Facebook, X (Twitter), Instagram, TikTok) to access diabetes education resources.

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* 13. I have been given access to Zoom or onsite group sessions.

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* 14. I am able to get services in the language of my choice.

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* 15. West Toronto Diabetes Education Program resources provided through Facebook, X (Twitter), Instagram, and Website are effective in supporting my self-management.

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* 16. West Toronto Diabetes Education Program resources provided to me though printouts, mail, or email are effective in supporting my self-management.

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* 17. My healthcare provider at West Toronto Diabetes Education Program spends enough time with me and addresses my questions.

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* 18. My health care provider at West Toronto Diabetes Education Program involves me in decisions and options for managing my diabetes.

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* 19. Staff at West Toronto Diabetes Education Program have provided me with the skills and knowledge I need to help me manage my diabetes.

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* 20. My healthcare provider at West Toronto Diabetes Education Program helps me to set up personal goals (like healthy eating and managing my diabetes etc).

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* 21. This diabetes program has increased my knowledge of my condition.

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* 22. Staff at West Toronto Diabetes Education Program explain things in a way that is easy to understand.

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* 23. The onsite and virtual groups that are offered (example: Introduction to Diabetes, Physical Activity, and Cooking Workshops) meet my needs.

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* 24. This diabetes program is having a positive impact on my diabetes management.

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* 25. OVERALL, I am satisfied with the care and services provided at West Toronto Diabetes Education Program.

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* 26. What else would you like to see offered?

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* 27. Comments/ Feedback

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* 28. My Success Story ( if you wish, please share your accomplishments in managing your diabetes, blood sugar, physical activity and/or quality of life )

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* 29. How did you hear about West Toronto Diabetes Education Program?

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