Please confirm which of the following apply to you.

On a scale of 1 -5, please answer the statements below:

I am satisfied with my life 

1= Strongly disagree     5= Strongly agree

I know enough about my health

I manage my risk of diabetes well

What would you like this course to help you achieve? Some of the things people write about are… eating healthier, giving up smoking, taking better control of blood glucose levels, attending scheduled check up appointments or increasing physical activity.

How important is it for you to reach the goals you’ve set?

1= Not important 5= Very important

How are you going to reach your goals?

What might stop you from reaching your goals and how can you overcome these barriers?

How confident do you feel in achieving what you would like to?

1= Not confident 5= Extremely confident