SURVEY

Short Survey

* Indicates required field

How did you hear about this site? *

Internet Search Advertisement Friend Other

If Other please specify: *

What is your interest in stroke? *

survivor caregiver family friend professional

How satisfied were you with site? *

Very Satisfied Satisfied Neutral Unsatisfied Very Unsatisfied

Submit

* Indicates required field

What online events have you attended? *

Support meetings Exercise classes Games Chat Guest speaker Other

Select all attended.

If Other please specify: *

How satisfied were you with the event? *

Very satisfied Satisfied Neutral Not Satisfied

What is your age? *

Less than 13 13-18 19-25 26-35 36-50 Over 50 Prefer not to say

Submit

Thank You

Contact Us
Survivors 4 Survivors

Email: [email protected]
Phone: 845.531.9968
or 855-SS4-STROke
501c3 Nonprofit