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Type 2 Diabetes
Risk Questionnaire
Please fill out the information below. All fields are mandatory
Step 1 of 2
Health Information
Gender
Weight (Kg)
Height (ft or cms)
Age
Waist size (inches or cm)
Physically active for more than 30 minutes every day?
Frequency of eating vegetables and fruits?
Ever taken medication for high blood pressure on a regular basis?
Ever found to have high blood glucose (e.g. in a health examination, during an illness, during pregnancy)?
Grandparent, aunt, uncle, or first cousin diagnosed with diabetes (type 1 or type 2)?
Parent, brother, sister, or own child been diagnosed with diabetes (type 1 or type 2)?
Continue to Step 2
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