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ABOUT
–
OUR LEADERSHIP
OUR STORY
JOIN OUR TEAM
E-NEWSLETTER
–
PHOTO GALLERY
ANNUAL REPORT
LOCATIONS
CONTACT US
PROGRAMS
–
REFER A CLIENT
DIABETES SERVICES
DIABETES DAYTON
CANCER SERVICES
HOME DELIVERED MEALS
SENIOR FARMERS MARKET
WELLNESS SERVICES
–
CARRIE’S CAFE & SENIOR DINING CENTERS
HELP-AT-HOME
PERSONAL EMPOWERMENT SERVICES
HIV/AIDS NUTRITIONAL SUPPORT
SENIOR PET CARE
VISITING NURSES
SUPPORT
–
DONATE
PLANNED GIVING
LEGACY ENDOWMENT CAMPAIGN
ENDOWMENT RESOURCE DIRECTORY
LIFECARE ALLIANCE STORE
–
SHOPPING REWARDS
Cancer Thrift Shops
SOCIAL ENTERPRISE
VOLUNTEER
VOLUNTEER APPLICATION
Blog
Referrals
Volunteer
Give Now
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Central Ohio Diabetes Association
Provider Survey
Step
1
of
3
33%
Provider Survey
What is the name of the organization that you work for? (Optional)
Would you like to be added to our contact list? If so, please provide your email address here.
Where are you located? (ZIP code)
*
What service field do you work for?
*
Choose one.
Diabetes Clinic/Endocrinologist/Hospital Office
Other Health Related Clinic/Hospital Office
Community/Nonprofit organization
FQHC
K-12 School
Public Health office
Higher Education
Other government office
Provider Survey
How many people do you serve with diabetes?
*
Do you serve more type 1 or type 2?
*
Type 1
Type 2
How many people do you serve for other services?
*
What services do you offer those living with type 1, type 2, or pre-diabetes?
*
What are you seeing as far as gaps in services for those living with diabetes?
*
Based on your experiences, what do you believe the diabetes community needs to most at the moment?
*
Have you ever worked with CODA?
*
Provider Survey
What is your role?
*
Choose one.
School nurse
Teacher/professor
Administrator
Other support staff
School Providers
Do you get training?
*
Yes
No
Is the training helpful and robust?
*
Yes
No
Do you feel you could use more support? If so, what would you want?
*
What do you think is the biggest issue facing your students living with any kind of diabetes?
*
Based on your experiences, what do you believe the diabetes community needs the most at the moment?
*
Have you ever worked with CODA?
*
What is the name of the organization that you work for? (Optional)
*
School Nurses
How many people do you serve with diabetes?
*
Do you serve more type 1 or type 2?
*
Type 1
Type 2
How many people do you serve for other services?
*
What services do you offer those living with type 1, type 2, or pre-diabetes?
*
What are you seeing as far as gaps in services for those living with diabetes?
*
Based on your experiences, what do you believe the diabetes community needs to most at the moment?
*
Have you ever worked with CODA?
*
What is the name of the organization that you work for? (Optional)
Are you provided specific training for the care of diabetic students?
*
Yes
No
Do you provide training to teachers/administrators/other staff on diabetic care for students? (Including signs of highs/lows and what to do in an emergency)
*
Yes
No
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