Diabetes Self-Management Education Survey 1. The purpose of the survey is to learn more about Floridians' knowledge of diabetes self-management education (DSME). This survey will also help us understand the impact of recent radio and commercial advertisements that encourage people with diabetes to attend DSME. Question Title * 1. Please check all the statements below that apply to you.I want to learn more about diabetes self-management education... because I have diabetes. because I have a loved one with diabetes. because I am a professional working with diabetes. Other (please specify) Question Title * 2. How did you hear about diabetes self-management education (friend, family member, doctor, web search, etc.)? Question Title Question Title * 3. Have you seen the diabetes self-management education television ad featuring this man in the last 3 months? Yes, I have seen this person on TV. No, I have not seen this person on TV. Question Title * 4. Have you heard a radio commerical about diabetes self-management education in the last 3 months? Yes No Question Title Question Title * 5. Did this man's story help you decide to learn more about diabetes self-management education? Yes No I did not see this commercial on TV or hear it on the radio. Question Title * 6. Did you ask your doctor for a referral to diabetes self-management education after hearing this man's story? Yes No I did not see this commercial on TV or hear it on the radio. Question Title * 7. Are you planning to go to diabetes self-management education? Yes No I am going to encourage my loved one with diabetes to go I am going to encourage my patients to go to Question Title * 8. If you are not planning to attend diabetes self-management education, please select the reason(s) below. Check all that apply. I can't afford the insurance co-pay/deductible I don't have transportation I don't need it I don't like group classes Classes are not offered at a good time or day I already attended diabetes classes Other (please specify) Question Title * 9. Please enter any comments you would like to share. Question Title * 10. If you would like to receive a free copy of the cookbook "Diabetes Meals on $7 a Day--Or Less!" please enter your mailing address below.Cookbooks are for Florida residents only and will be offered while supplies last. Name: Address: Address 2: City/Town: ZIP: Done