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*
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*
Please remove '0' from the beginning of your phone number and do not use any spaces. Examples: landline: +61299990000, mobile: +61414000000
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*
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*
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Are you an NDSS registrant?
*
Are you an NDSS registrant? *
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How often do you test your blood glucose levels?
*
How often do you test your blood glucose levels? *
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2-3 times a day
4-5 times a day
6 or more times a day
What type of diabetes do you have?
*
What type of diabetes do you have? *
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Pre diabetes
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What type of treatment do you follow?
*
What type of treatment do you follow? *
Insulin Pen/Injection
Insulin Pen & Tablets
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Diet
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No Treatment
What meter do you currently have?
*
What meter do you currently have? *
Accu-Chek Guide or Accu-Chek Guide Me
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Don't have an existing meter
Leave this field blank
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