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1
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Please mark the strength of your interest on the scale (1 is low, 5 is high).
1
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High | N/A
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| Prevention |
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| Survivor Stories |
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| Rehabilitation & Recovery |
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| Physical Rehabilitation |
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| Assistive Technology |
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| Thinking & Emotional Skills |
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| Sexuality |
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| Recovery Long Term |
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2
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Please mark the strength of your interest on the scale (1 is low, 5 is high).
1
Low | 2
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High | N/A
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| Caregiver & Family Coping |
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| Costs & Insurance |
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| Providers |
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| Employment |
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| Driving |
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3
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Please mark the strength of your interest on the scale (1 is low, 5 is high).
1
Low | 2
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High |
| Medical Consequences |
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| Anger |
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| Coma |
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| Concussion |
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| Depression |
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| Epilepsy/Seizures |
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| Medications |
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| Memory Loss |
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| Spasticity |
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| Stress |
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| Substance Abuse |
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4
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Please mark the strength of your interest on the scale (1 is low, 5 is high).
1
Low | 2
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High |
| Brain Injury in Children |
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| Firearm Related TBI |
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| Violence Related TBI |
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5
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Please indicate any other topic(s) of interest to you.
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6
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Please indicate your relationship to brain trauma. Check as many as apply
| Survivor |
| Caregiver for Child up to 18 years old |
| Caregiver for Adult |
| Medical or Healthcare Professional |
| Researcher |
| Social Worker |
| Writer |
| Other, please specify |
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7
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How many years have you had a connection(s) with brain trauma?
| Less than one year |
| One to three years |
| Four to 10 years |
| More than 10 years |
| Let me clarify... |
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8
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Please rate any of the following TBI websites you know for their
usefulness (1 is low and 5 is high).
1
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High | N/A
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| American Occupational Therapy Association (AOTA) |
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| American Physical Therapy Association (APTA) |
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| American
Speech-Language Hearing Association (ASHA) |
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| Brain
Injury Association USA (BIA) |
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| BrainLine.org |
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| Centers for Disease Control and Prevention (CDC) |
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| National Institutes of Health (NIH) |
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| Seattle Children's |
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| University of Washington Medicine |
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| University of Washington TBI Model System |
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| Washington State TBI Council |
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| Washington State TBI Support Group |
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