1 OF 5: HEALTH SURVEY

Please complete this 1-minute survey designed by the Centers for Disease Control (CDC) to see if you qualify.

If you qualify, we will then check if you’re eligible for Lark through your Medicare plan.

Let’s find out if you qualify!

Next, let's find the right Lark program for you.

Please answer the following questions designed by the Center for Disease Control (CDC) to see which Lark program you may qualify for.

How much physical activity do you usually get each week?

Do you identify as Asian or Asian American?

Based on a blood test in the past year, have you been told by a healthcare professional that you’re at risk for diabetes or have prediabetes?

Have you had a blood test in the last 12 months?

Are you currently undergoing treatment for any type of cancer (e.g. chemotherapy, radiation)?

Have you been diagnosed with any of the following conditions? Choose all that apply.

Have you been diagnosed with any of the following conditions?

Have you been diagnosed with any of these conditions? Check every condition below that applies to you.

Have you been diagnosed with type 1 or 2 diabetes?

Do you have a mother, father, sister, or brother with type 2 diabetes?

Have you ever been diagnosed with Gestational Diabetes?

Have you been diagnosed with any heart conditions?

Have you been diagnosed with high blood pressure?

Do you have Medicare Part B (Fee for Service, FFS)?

Any current or prior eating disorders such as anorexia or bulimia?

Are you currently taking a GLP-1 Medication for any of the following diagnoses: