Type 2 Diabetes Prevention Crowd Sourced Project

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Join Us:

Help us take on Type 2 Diabetes! Your participating has the potential to impact the lives of millions of people suffering from type 2 diabetes by proving a promising non-pharmacological, functional medicine approach to treating type 2 diabetes.

Why join this study?

Feel the satisfaction of playing an integral part of the ground breaking wellness solution, discover key insights about your biology while learning the valuable lifestyle skill of managing your insulin which is known to result in higher energy levels, healthy weight loss, reduced inflammation, better moods, reduced heart disease and Alzheimer’s Disease risks.

What we need:

Please answer the following questions to help us better understand if you are an ideal candidate for this study.

Next Steps:

We will be notifying all applicants if they have or have not been selected to this study by EOD June 5th 2019.

Email *

Name *

First and last name

Email *

Phone number *

1. Have you been diagnosed with Type 2 Diabetes? *

2. Are you currently pregnant?

3. Do you have any serious disease now or in the past? *

4. If you answered yes to question #3 please state which one? *

5. If you answered yes to question #3 please state how long ago? *

6. Are you located in Alberta and willing to travel to Calgary (Twice, once in beginning once at end of project) *

Yes

7. Are you willing to commit to participating in 12 weeks of webinars? *

Yes

Clear form

Never submit passwords through Google Forms.

This form was created inside of brainmechanics.net. Report Abuse

Forms