Skip survey header

Screening

Page One

Diabetes Stress Relief Study
Eligibility Form

Thank you for your interest in participating in the Diabetes Stress Relief Study at the University of South Florida!   Please take a moment to answer the questions below to determine whether you are eligible to participate in the study. 


This question requires a valid number format.
2. Have you been diagnosed with Type 2 Diabetes? *This question is required.
This question requires a valid percent format.
In order to participate, your A1c must be tested within 2 months of beginning the study. If you have an upcoming appointment or plan to schedule a lab test to measure your A1c, we can put you on the waiting list to start the study after that time.

Would you like us to put you on the waiting list?
*This question is required.
5. This study will require you to have your A1c tested within 3 months after completing the program. Would that be possible for you?

Please note that the program takes about 3 months to complete, so if you get your A1c tested every 3-6 months, this should fit into your schedule. 
6. Have you had any medication changes since your last A1c test?
7. Do you have access to a computer with internet access?
8. Does that computer have the ability to play sound, either through speakers or headphones?
9. The computer program used for the study requires the use of Adobe Reader and Macromedia Flash Player. Do you have these programs on your computer?
These programs are available for free to download online. Are you able and willing to download and install these programs on the computer you plan to use?