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LEVEL Lifers
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Become a LEVEL Lifer

Join our mission and become a LEVEL Lifer. Lifers are strong, determined, and brave, which are just some of the traits that diabetics have gained in their journey with T1D. Become a LEVEL Lifer and share your inspiring stories with our community!

* indicates required fields

Name*

First Last

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Age Range*

0-17

18-25

26-40

41-54

55+

Gender*

Female

Male

Gender Diverse

Other

Type of Diabetes*

Type 1

Type 2

How many instances per week where you battle regulating your low blood sugar?*

1-3 Instances

4-5 Instances

6+ Instances

What do you treat your low blood sugar with now?*

Juice

Candy

LEVEL Life glucose gels

Other

Do you take insulin?*

Yes

No

How many times a day do you test your blood sugar?*

1-3 times/day

4-6 times/day

7+ times/day

What products do you use to help manage your diabetes?

Select all that apply

Insulin Pump

Insulin Shots (syringes)

Pen Needles

Glucose Meter & Strips

Glucose Gels

What age were you diagnosed with diabetes?*

0-5

6-10

11-15

16+

How long does it typically take you to come up when you are low?*

Under 1 hour

1-2 hours

3 hours+

Other

Have you tried our LEVEL Life Glucose Gels?*

Yes

No

How did you hear about LEVEL?

Facebook

Instagram

Friend/Family

Other

Please tell us how LEVEL Life Glucose Gels have helped treat your low blood sugars.*

Please share a story that comes to mind that portrays your personal experience and journey with diabetes (playing on a sports team, managing lows while traveling, etc.).*

a minimum of 250 characters is required

What is your biggest challenge with diabetes?

a minimum of 250 characters is required

What have you learned from your experiences with diabetes?

If you had one piece of advice for someone with diabetes, what would it be?

Who has helped you the most manage your diabetes? What has helped you the most manage your diabetes?

Please share your Instagram handle if you would like us to tag you in our marketing efforts.

Attach a photo of yourself

Accepted file types: jpg, jpeg, png, gif.FileTitle

either with LEVEL Life Glucose Gels or solo shot - to be featured on our site!

Can LEVEL share your story and photograph on social platforms?*

Yes, feel free to share my story

No, I prefer to keep my story private

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