Sign up for Personalized Reminders

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Please fill in your contact information to enable us to provide you personalized details about events and resources specially designed for you.

Name *

Name of Child (In case your child has diabetes)

Date of Birth *

YYYY

Gender *

Male

Female

Prefer not to say

Phone # *

WhatsApp # or Signal # (If available)

Email Address

City *

Do You have diabetes? *

Yes

Which Type? *

Diabetes Type 1

Diabetes Type 2

Other

If No, Please specify your Relationship with Diabetes *

My Kid has Type 1 Diabetes

My Kid has Type 2 Diabetes

My Spouse has Type 1 Diabetes

My spouse has Type 2 Diabetes

My friend has Type 1 Diabetes

My friend has Type 2 Diabetes

My parents have Type 1 Diabetes

My parents have Type 2 Diabetes

I am a professional dealing with diabetes

No Relation with Diabetes

I have Diabetes

Other:

Required

Date/year of diagnosis *

Are you vaccinated for COVID-19? *

Yes

Partial

I hereby give my consent to Meethi Zindagi's to use my picture/video on social media taken during the event. *

Yes

Optional

Social Media (Enter your profile handle)

Facebook

Instagram

Twitter

*Disclaimer : Your personal data is protected as per our data privacy policy and will only be used by Meethi Zindagi for providing you personalized information about resources, services and event updates. The demographic data / statistics may be used for developing better programs, services and projects to suit the group needs, or for demographic research and may be shared with our partners and affiliates without revealing any personal information to any third party.

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