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Diabetes Action Plan Survey - Hmong

Kev Ntsuam Xyuas Txoj Phiaj Xwm Saib Xyuas Mob Ntshav Qab Zib

Koj qhov kev koom tes hauv kev ntsuam xyuas 7 feeb no yuav pab Wisconsin Department of Health Services (Lub Tsev Hauj Lwm Saib Xyuas Cov Kev Pab Cuam Kev Noj Qab Haus Huv) tau npaj Diabetes Action Plan (Txoj Phiaj Xwm Saib Xyuas Mob Ntshav Qab Zib). Qhov kev ntsuam xyuas no yog ib txoj hauv kev rau koj qhia rau peb paub seb koj xav pom dab tsi suav nrog hauv txoj phiaj xwm, thiab qhia peb tias cov neeg nyob nrog los sis saib xyuas cov neeg mob ntshav qab zib hauv Wisconsin muaj teeb meem dab tsi. Peb kuj tseem xav hnov txog cov kev cov nyom rau koj lub zej zog txoj kev noj qab nyob zoo tag nrho, thiab cov peev txheej dab tsi xav tau los daws cov kev cov nyom no. Qhov kev ntsuam xyuas no yuav kaw rau lub Kaum Ob Hlis Ntuj Tim 31, 2022. 

Yog tias koj muaj lus nug txog daim ntawv ntsuam xyuas no, xa email mus rau Chronic Disease Prevention Program (Lub Khoos Kas Tiv Thaiv Tus Mob Ntev) ntawm dhschronicdiseaseprevention@dhs.wisconsin.gov. Peb ua tsaug rau koj lub sij hawm thiab cov tswv yim.

1. Dab tsi hauv qab no piav qhia koj lub luag hauj lwm thaum hais txog tus kab mob ntshav qab zib? Kos rau txhua yam uas siv tau. *This question is required.
  • * This question is required.
2. Xaiv lub (cov) cheeb tsam nroog thiab/los sis (cov) haiv neeg ntawm pab pawg neeg rau koj tus kheej thiab/los sis koj lub koom haum. Kos rau txhua yam uas siv tau. *This question is required.
  • Counties
  • Tribal Nations
2. Qhov twg ntawm cov cheeb tsam hauv qab no koj txaus siab rau? Kos rau txhua yam uas siv tau. *This question is required.
  • * This question is required.
2. Hauv lub sij hawm 12 lub hlis dhau los, puas muaj lub sij hawm twg uas koj los sis ib tus neeg koj paub tias muaj mob ntshav qab zib xav tau ib yam hauv qab no, tab sis tsis tau txais vim yog tus nqi? Kos rau txhua yam uas siv tau:
  • * This question is required.
2. Koj xav tias Diabetes Action Plan (Txoj Phiaj Xwm Saib Xyuas Mob Ntshav Qab Zib) tom ntej yuav tsum tsom mus rau dab tsi? Qib 1-7 uas 1 yog qhov tseem ceeb siab tshaj plaws, thiab 7 yog qhov tseem ceeb qis tshaj plaws. *This question is required. Note: for the following table each column is restricted to a single answer across all rows.
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2.

Koj yuav piav qhia txog koj lub zej zog li cas?

2. Koj yuav piav qhia txog koj tias yog poj niam txiv neej li cas?
2. Koj yuav piav qhia txog koj haiv neeg li cas? Kos rau txhua yam uas siv tau.
2. Koj puas tau txheeb xyuas tias yog neeg Hispanic los sis Latino?