Type 1 Buddies (Mentors)

Purpose: To learn about the buddy’s experience and match them with a younger or newly diagnosed type 1 child based on personality and comfort. 

My mission is to create a compassionate community where children and families affected by Type 1 Diabetes feel understood, supported, and never alone—offering guidance, encouragement, and a true sense of belonging.

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Basic Info for Type 1 Buddy Mentors
Ideally Buddy mentors ae above the age of 13 years old, and have had diabetes for over 2 years.  These “buddies” provide encouragement, share real-life tips, and help kids know they are not alone. 
Full name  *
Age  *
The date you were diagnosed with Type 1 Diabetes  *
What state and city do you live in? This might help us pair you with a buddy that might live close to you.
Can you share any hobbies or activities you enjoy? This is to help us match you with a buddy that might have similar hobbies.  
How comfortable are you talking about diabetes with others? (scale 1–5)
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What kind of buddy relationship are you hoping for?
(Supportive friend, teaching, fun buddy, mix of all three)
Would you prefer your buddy to be:  
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Are you on a pump 
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Are you on a CGM, if yes what kind *
Communication Preferences
How would you like to communicate with your buddy?
(Options: Email, Text, Zoom, In person if possible) *
How often would you like to connect? *
Do you want to share anything else with us? 
Parent or Guardian information 
If you are under the age of 18 we will need your parent or guardian information 
Parent / Guardian Name  *
Parent email  *
Parent phone number *
Photo permission (optional, if I might share pictures of buddies on my site or social media) *
Mentor, Parent/guardian consent for participation :
By submitting this form, I give permission for Mia’s Type 1 Buddies to contact me first then my child using the information provided. I understand that participation is voluntary and that communication will be for the purpose of support, mentorship, and community connection related to Type 1 Diabetes. I may withdraw this consent or request that our information be removed from the program at any time by contacting the organizers.  
 *
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