Defeating Diabetes - Free Talk, Dubai, 29.8.2019
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Thank you for your interest in Defeating Diabetes - Free Talk
Please complete the following form in order to register for our program
Name *
Email Address *
Mobile number *
City *
Area *
Country *
Profession *
No of person *
1. Are you a Diabetic? *
2. If yes, for how long
3. What impact Diabetes had on your life *
4. How committed are you to reversing Diabetes?  (on a scale of 1 to 10) *
5. Are you willing to put in necessary efforts if we show you the way? *
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