KOI #insulin4all
Do you live (or care for someone) with diabetes in Kentucky, Ohio or Indiana? We are a group of volunteer advocates working on #insulin4all action in the region. We want to know how the high cost of insulin has impacted you. Answer the questions below on behalf of yourself or someone you care for and join our efforts.
By sharing your story with us, you are consenting to allow us to use it in our advocacy efforts to push forward legislation for transparency from insulin manufacturers, and ultimately lower prices. Use of your story includes the possibility of it being shared with the public, lawmakers and members of the media.
If my story and other personal health details are shared publicly I wish to: *
State *
Name (first and last) *
Your answer
Email Address *
Your answer
Which brand(s) of insulin do you take? *
Required
Please share your approximate monthly costs of insulin.
Your answer
Have you ever had to ration or cut back on the amount of insulin you take because of the high cost? *
If yes, please tell us about this.
Your answer
How has the high cost of insulin impacted you financially, emotionally, etc.? Have you had to sacrifice anything (rent, food, other purchases, vacations, etc.) to pay for insulin? *
Your answer
Is there anything else you want to share about how the price of insulin has impacted you and/or your family?
Your answer
I would be happy for KOI volunteers to contact me (check all the apply):
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