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DIABETIC QUESTIONNAIRE (To be completed by Proposed Life Assured) GOAL SOLIDI FENCING MANI (Untuck dilengkapkan ole Hay at Yang Dicadangkan) Proposed Life Assured : Proposal/Policy No. Hay at Dicadangkan
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Read each question carefully before answering.
02
Provide accurate and honest information about your medical history, symptoms, and lifestyle habits.
03
If you are unsure about any question, consult with your healthcare provider for clarification.
04
Double-check your responses before submitting the questionnaire to ensure completeness and accuracy.

Who needs new diabetes questionnaire to?

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Individuals who have been diagnosed with diabetes or suspect they may have diabetes.
02
Healthcare providers who are assessing a patient's risk for diabetes or monitoring their diabetes management.
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The new diabetes questionnaire is used to gather information regarding an individual's diabetes status.
Individuals who have been diagnosed with diabetes are required to fill out the new diabetes questionnaire.
The new diabetes questionnaire can be filled out by providing accurate information about one's diabetes diagnosis and management.
The purpose of the new diabetes questionnaire is to assess and monitor an individual's diabetes status.
Information such as date of diagnosis, type of diabetes, current treatment plan, and glucose monitoring results must be reported on the new diabetes questionnaire.
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