Health Pledge

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Health Pledge

The details you provide here will be added to your customized certificate of Pledge and sent to your email address provided here. Your mobile no., if shared, shall be used for promotional IEC and BCC activities. All your details will remain confidential and shall not be spammed. You can speak up your mind freely.

Your First Name *

Your Last Name *

You are taking this pledge for *

Yourself

Someone you care for

Tell us about your age *

Less than 20

20 to 30

30 to 40

40 or more

Tell us about your Gender *

Male

Female

Prefer not to say

Tell us about your Health profile *

You or your loved one has recently (less than 1 year) been diagnosed with diabetes and you are doing it to help him/yourself

You have had diabetes for more than 1 year but you are more committed to your health now and want to help yourself/your loved one

You/your loved one do not have diabetes as of now but are at risk of diabetes and you want to help yourself/your loved one

You are a health enthusiast and want to learn more about diabetes for your own/family's safety

You are at war with diabetes and believe it must be taken head on to help more and more people around you

PLEDGE: I solemnly swear that I will commit myself to fight diabetes with all my might and will help create a better life, a better world for all diabetics out there. I acknowledge that even a small step can make a huge difference in the society at large. *

I Swear

Now that you have pledged your allegiance towards this noble cause, how would you like to fight diabetes? *

I will do it with physical exercises and weight loss

I will do it with diet changes i.e. restricting calories and replacing daily items with healthier alternatives

I believe in non-medicinal ayurvedic/homeopathic products

I will go for medicinal ayurvedic/homeopathic therapies to treat/prevent diabetes

I will go for allopathic medicines and therapies

Required

What do you think is going to happen with your chosen method of fighting diabetes? *

My diabetes will be cured forever and I will go back to my normal life

Diabetes can only be controlled but I will learn to live with it and prevent its complications

I am not sure right now but want to learn more

Your phone/whatsapp no. is (This is optional; you may provide your details to receive promotional offers/ discounts/freebies etc.):

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