$value ) { if (strpos($key, "answer_") !== false) { $answer = substr($key, 7); if (gettype($value) == "array") { $value = implode($value, ", "); } $answers[0][$answer] = $value; } } $quiz = new Quiz( "demographics", $mysqli ); $quiz->addQuizAnswers( $answers ); setcookie("DemographicsAnswered", 1, time()+60*60*24*365, "/", ".diabeteshealth.com"); header( "Location: http://digital.diabeteshealth.com/" ); exit; } include( $_SERVER['DOCUMENT_ROOT'] . "/includes/ads.php" ); include( $_SERVER['DOCUMENT_ROOT'] . "/includes/description.php" ); $htmlTitle = "Diabetes Health - Survey"; $htmlDescription = "Diabetes Health - " . $description; include( $_SERVER['DOCUMENT_ROOT'] . "/header.php" ); ?>

Please Take Our Brief Survey

We'd like to hear from you! Please take a moment to fill out this short survey. We will then redirect you to Diabetes Health Digital Advantage™.

The survey is completely anonymous, and no personal data is collected. Thanks for your participation.

No thanks, take me directly to Diabetes Health Digital Advantage™

1. Are you:
Type 1
Type 2 (no medication)
Type 2 (medication only)
Type 2 (medication & insulin)
2. How many times a day do you test your blood glucose?
1-3
4-6
7-8
8 or more
I use a CGM
3. Which insulin delivery device do you use?
Syringe
Insulin Pen
Insulin Pump
Insulin Pump + CGM
None / Other
4. Sex:
Male
Female
5. Age:
Under 18
18-25
26-40
41-55
56-65
66 and over
6. Income:
Under $25,000
$25,000-$50,000
$50,000-$100,000
$100,000+
7. Education level:
No High School Degree
High School Graduate
College Graduate
Post-Graduate
8. Regularly used meds:
Cholesterol
Heart disease
Depression
Neuropathy
Sexual health
Skin problems