Welcome to HealTogether

Your input will help us to provide you with customized information on diabetic foot stores. Fill out the information below and receive a free pedometer.

Contact information:

*
*
*
*
*
*
*
*

1. How long have you had diabetes?

1-5 Years6-10 Years11-15 YearsOver 15 Years

2. Do you have one or more of the following:
peripheral artery disease (PAD), reduced blood flow to your legs, peripheral neuropathy, tingling, burning or numbness in your lower legs or feet?

YesNo

3. Do you currently have a foot sore?

YesNo

4. Who is treating the foot sore?

Wound care specialist or wound care centerMy regular doctor
PodiatristI am treating it my self
My diabetes doctorIt is not being treated

5. Have you had a foot sore in the past?

YesNo

I agree that the information I am providing may be used by Shire Regenerative Medicine, Inc., its affiliates or vendors to keep me informed regarding disease education. Shire Regenerative Medicine may also combine the information I provide with information from third parties so as to better match these offers with my interests. Shire Regenerative Medicine will take appropriate measures to protect my information.

I can stop Shire Regenerative Medicine from sending me future communications by emailing info@healtogether.com, sending a brief note with my name and address to Shire Regenerative Medicine, attention HealTogether at 11095 Torreyana Road, San Diego, CA 92121, or by clicking on the "unsubscribe" link, which will be available in future e-mail communications. By providing my information to Shire Regenerative Medicine and acknowledging below, I certify that I am at least eighteen (18) years of age.

Click here to agree

I am interested in participating in diabetic foot ulcer and/or wound healing market research and would like to be contacted further by Shire or its third parties.

Click here to agree