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2019 ConnecT1D Adult Retreat Registration | June 22 - 23
A. Event Tickets

$
B. Attendee Registration Details
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First Name
Last Name

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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country

2B. Attendee #2 Registration
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First Name
Last Name
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C. Pre-Conference Questionaire
Tell us a little more about your Type 1 experience, so we can tailor the retreat to best serve you!
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Survey

Please respond with how much you either agree or disagree with regards to the following statements.

Feeling isolated affects the way I manage my diabetes.
Feeling shameful affects the way I manage my diabetes.
I have the knowledge and skills I need to manage my diabetes well.
I feel supported by others in the T1D community.
I feel positive about the way I manage my T1D.
I am reluctant to let others know that I have T1D.
I have hope for a healthy life with T1D.
I feel overwhelmed by diabetes and its impact on my life.
My connections with others with Type 1 positively impacts my diabetes management.

Thank you for your input!