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Consent?
We respect your privacy and request to collect your contact information and information about your Fleet to provide you with a report illustrating cost savings a Diabetes Prevention Program can contribute towards your Health & Wellness programs cost. You also agree the information may be used by Healthy Trucking of America to contact you about other programs we provide. See Full Disclosure

If you're a fleet looking to reduce your healthcare cost for professional drivers and increase driver retention, we've got you covered. 25 years of experience working with fleets have helped us create a simple straightforward ROI Analysis that shows you can't not afford to put in a DPP. Healthy Trucking of America (HTA) has been working with Association of Diabetes Care & Educations Specialists (ADCES) raising awareness about the prevalence of prediabetes amongst the driver community by giving away FREE DPP pilot programs to Fleets expanding coverage of the National DPP lifestyle change program. This questionnaire will collect information about your interest and experience with the National Diabetes Prevention Program (National DPP) lifestyle change program. Your information will contribute to help improve the health and wellness of Professional Drivers all across America. It only takes 5 minutes to complete and will provide you with an ROI that really works.
Name*
First Last
Organization*
USDOT Number
Title
Email*
Phone Number*

Where is your organization headquartered?(City,State)
In which state(s) do your employees work?
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Please tell about your drivers
How many are Owner Operators?
Please enter a number from 0 to 1000000.
How many are Company Drivers?
Please enter a number from 0 to 1000000.
What is the % of drivers you will replace because they cannot pass a DOT Medical Examination?
How much does it cost you to replace a driver?
Number of non driver employees in your organization
Please enter a number from 0 to 1000000.

Organization’s benefits
Approximately how many total lives are covered under your organization’s benefits?
Please enter a number from 0 to 1000000.
What is your organization’s benefit structure?
Do you use a third party administrator to manage your benefit program?
What is the name of the TPA company?
Who is your current health insurance provider? Please list all if you have more than one.

Does your organization offer the National Diabetes Prevention lifestyle change program as a covered benefit?

Who is your DPP Provider?
What is name of DPP provider?
Please indicate if the National DPP lifestyle change program benefit is a wellness or medical benefit.
How is the National DPP lifestyle change program delivered to your employees? (Select all that apply)
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Does your organization intend to retain the benefit?
Please describe any successes or challenges your organization has had with implementing the benefit.

Does your organization's health plan or third party administrator (TPA) offer the National DPP lifestyle change program as an add-on benefit?
What do you see as barriers to coverage of the National DPP lifestyle change program? (Select all that apply)
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Please describe other

Do you have any questions about the NDPP?
I would be interested in someone contacting me about the following (select all that apply):
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ADCES Survey

We need your consent before we can proceed to generate your ROI Analysis