Madison SCI Group Survey

1. How long have you been a Madison Spinal Cord Injury group member?

How long have you been a Madison Spinal Cord Injury group member? < 1 year

1-2 years

2-3 years

3-4 years

4 + years

2. How long has it been since your, your family member or your friend's injury or diagnosis?

How long has it been since your, your family member or your friend's injury or diagnosis?

3. How easy or difficult do you find attending meetings and why?

	Very easy	Somewhat easy	Neutral	Somewhat difficult	Very difficult
Transportation	How easy or difficult do you find attending meetings and why? Transportation Very easy	Transportation Somewhat easy	Transportation Neutral	Transportation Somewhat difficult	Transportation Very difficult
Venue Location	Venue Location Very easy	Venue Location Somewhat easy	Venue Location Neutral	Venue Location Somewhat difficult	Venue Location Very difficult
Venue Accessibility	Venue Accessibility Very easy	Venue Accessibility Somewhat easy	Venue Accessibility Neutral	Venue Accessibility Somewhat difficult	Venue Accessibility Very difficult
Day of the week	Day of the week Very easy	Day of the week Somewhat easy	Day of the week Neutral	Day of the week Somewhat difficult	Day of the week Very difficult
Time of Meeting	Time of Meeting Very easy	Time of Meeting Somewhat easy	Time of Meeting Neutral	Time of Meeting Somewhat difficult	Time of Meeting Very difficult
Cost	Cost Very easy	Cost Somewhat easy	Cost Neutral	Cost Somewhat difficult	Cost Very difficult

Other (please specify)

4. What do you find most and least helpful about the newletter? The website?

What do you find most and least helpful about the newletter? The website? Most Helpful
Least Helpful
Suggestions for improvement

5. Please list some activities or events you would like to participate in/attend in 2012-2013.

Please list some activities or events you would like to participate in/attend in 2012-2013.

6. Are there any activities that you have disliked in the previous year? Please explain why.

Are there any activities that you have disliked in the previous year? Please explain why. Name of Activity/activities:
Reasons: (Weather, Transportation, Cost, Time of Day,Other)

7. What activities did you do before your injury or diagnosis? Check all that apply.

What activities did you do before your injury or diagnosis? Check all that apply. Athletics/Sports

Outdoor/Recreational Activities

Arts & Crafts

Music (instruments/vocal/concerts)

Travel

Employment

Cooking/Baking

Social Outings

What activities would you like to do now?

8. What have you valued most about being a member of the Madison Spinal Cord Injury Group? (Check all that apply)

What have you valued most about being a member of the Madison Spinal Cord Injury Group? (Check all that apply) Companionship/Friendship

Social Outings

Education

Resources

Support

Other (please specify)

9. What, if anything have you valued least about being a member of the Madison Spinal Cord Injury Group? Please explain.

What, if anything have you valued least about being a member of the Madison Spinal Cord Injury Group? Please explain.

10. What is one thing you would like to see changed within the Spinal Cord Injury Group in the upcoming year? Please explain.

What is one thing you would like to see changed within the Spinal Cord Injury Group in the upcoming year? Please explain.

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