Consultation survey
Please fill out and send us the survey
Do laboratory analyzes
You will get an answer if and when you will be admitted to our counseling center in the 2023 - 2024 period
Name and surname
Date of birth?
Your e-mail
Your phone number
Height (cm)
Weight (kg)
Waist circumference (cm)
Type of diabetes - choose from the drop-down menu
When were you diagnosed with diabetes?
Reasons for reporting to a doctor ?
Glucose finding and initial therapy
Glucose finding and present therapy
Complications due to diabetes
Do any of your family members have diabetes, and who?
Bad habits
What is the result you would be satisfied with?
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