Be the best kind of influencer!Shape the Future of Diabetes CareUse your unique perspective to help improve the lives of people with diabetes. Sign up for our research registry to make your voice heard across the diabetes community. Fill out this form to be informed about opportunities to participate in research related to diabetes and young adults! First Name: Last Name: Preferred Email: Preferred Phone: Birthday: What are your preferred pronouns?Please select... She / Her Series He / Him Series They / Them Series Other Prefer not to say What is your race/ethnicity? Please select... Asian or Pacific Islander Black or African American Hispanic or Latino Middle Eastern or North African Native American or American Indian White Other Two or more of these options I prefer not to sayWe use this data to ensure that we are serving diverse communities of people with diabetes. What is your connection to diabetes?Please select... I have type-1 diabetes I have type-2 diabetes I have another form of diabetes I do not have diabetes I prefer not to say Date of Diagnosis: Contact Information
