CONNECT1
Full `name:
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Age :
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Gender :
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Mobile number (please include country code):
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Email:
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Preferred contact method:
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Instagram handle:
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Where are you based? Please indicate your timezone:
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What is their average time in range across 7 days?:
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What is your relationship to the diabetic?:
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Are they dependant on you?:
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What is your key reason for wanting to learn more about diabetes on their behalf:
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What was their recent A1C (in the last 2 months), or your EA1C according to CGM:
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How much are you able to financially commit to per month:
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150-200 GBP
200 - 250 GBP
250 + GBP
How did you hear about me?:
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