I pledge to get screened for type 1 diabetes

*Required

First name*

Last name*

Email address*

Phone number to learn more via text

I agree to receive text communications from Type1Talk and have read and accepted the SMS Terms and Conditions.*

I would like to receive direct mail.

State*

I'm interested in screening for*

Myself

My loved one

Does anyone in your family have type 1 diabetes? * Please select one *

I have type 1

I have at least one child with type 1 and one without

All my children have type 1

Someone else in my family has type 1

No one in my family has type 1

I agree to Terms and Conditions and Privacy Policy*

I certify that I am at least 18 years old and a US resident.*

By checking this box, I understand and consent that Sanofi US and its contracted vendors acting on its behalf to collect and use the information I provide to provide services to me as well as educational support resources from Screenfortype1.com. This box must be checked in order to receive communications about information and educational resources regarding type 1 diabetes.*

By checking this box, I understand and consent that Sanofi US shares the information I provide with its contracted vendors acting on its behalf to provide services to me as well as educational support resources from Screenfortype1.com. This box must be checked in order to receive communications about information and educational resources regarding type 1 diabetes.*

You may have certain rights under applicable data privacy laws regarding the personal information that you provide, including the right to withdraw consent from future collection or sharing of your information. For further information regarding these rights, please reference Sanofi US Privacy Policies and Consumer Health Data Privacy Policy.

TAKE THE 1 PLEDGE to screen for type 1

TAKE A STAND WITH USHER AND ADAM SCHEFTER. Advocate to get yourself and your family screened for autoimmune type 1 diabetes.