American Diabetes Association: Survey - Florida: Let's Lower Insulin Costs!

Florida: Let's Lower Insulin Costs!

Your Info

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Name:

First Required	Last Required

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E-mail: Required

Street 1:

City/State/ZIP:

City	State	ZIP

Phone Number:

Yes, I would like to receive e-mail from American Diabetes Association

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Question - Required - What is your relationship to diabetes?

	I live with diabetes
	A family member or friend lives with diabetes
	Health care provider
	Other

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Question - Required - Have you or someone you care about been impacted by the high cost of insulin? Please share details, including whether this is for yourself, a family member, friend, or patient.

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Question - Required - I can help support ADA's work to reduce the insulin costs in Florida by doing the following:

	Contacting lawmakers (ADA will even draft an email message for you to personalize and send!)
	Calling my lawmaker (ADA will help!)
	I am willing to rovide testimony to state legislators