CCSVI at UBC MS Clinic - Information and Support Facebook Survey
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1. Getting to Know You

Let's find out a little bit about who visits this page! None of these questions are required and all information respects your privacy. All answers are completely anonymous.

1. Basic information:

Basic information: Gender
Age
Country
Occupation

2. How would you describe your interest in MS? Tick as many as apply.

How would you describe your interest in MS? Tick as many as apply. I have been clinically diagnosed with MS

I suspect I have MS

Someone related to me has been clinically diagnosed with MS

Someone related to me is suspected of having MS

A friend of mine has MS

A friend of mine is suspected of having MS

I work in a field supporting people with MS

I volunteer in a field related to MS

I am a physician with MS patients

I am with the media

Other (explain below, if necessary)

Explanation:

3. What has been your involvement with the MS Society? Check all that apply.

What has been your involvement with the MS Society? Check all that apply. None

Contributor to fundraising

Volunteer for less than 6 months

Volunteer for 6 months to 2 years

Volunteer for 2 to 5 years

Volunteer for over 5 years

Patient receiving services

Patient attending functions

Patient participating in fundraising

Volunteer Board member

Paid employee

Paid Executive member

Other (add coment below)

Comment:

4. Please use the following scale to answer these questions about your Facebook use:

	Rarely or Never (0-2 times/week)	Sometimes (3-5 times/week)	Frequently (6-10 times/week)	Very frequently (11+ times/week)
How often do you check your Facebook home page?	*Please use the following scale to answer these questions about your Facebook use: How often do you check your Facebook home page? Rarely or Never (0-2 times/week)	How often do you check your Facebook home page? Sometimes (3-5 times/week)	How often do you check your Facebook home page? Frequently (6-10 times/week)	How often do you check your Facebook home page? Very frequently (11+ times/week)
How often do you check the CCSVI at UBC Facebook page?	How often do you check the CCSVI at UBC Facebook page? Rarely or Never (0-2 times/week)	How often do you check the CCSVI at UBC Facebook page? Sometimes (3-5 times/week)	How often do you check the CCSVI at UBC Facebook page? Frequently (6-10 times/week)	How often do you check the CCSVI at UBC Facebook page? Very frequently (11+ times/week)
How often do you use Twitter?	How often do you use Twitter? Rarely or Never (0-2 times/week)	How often do you use Twitter? Sometimes (3-5 times/week)	How often do you use Twitter? Frequently (6-10 times/week)	How often do you use Twitter? Very frequently (11+ times/week)

5. Please use the following scale to answer these questions about CCSVI:

	Strongly disagree	Disagree	Neutral	Agree	Strongly agree
I believe CCSVI is associated with MS	*Please use the following scale to answer these questions about CCSVI: I believe CCSVI is associated with MS Strongly disagree	I believe CCSVI is associated with MS Disagree	I believe CCSVI is associated with MS Neutral	I believe CCSVI is associated with MS Agree	I believe CCSVI is associated with MS Strongly agree
I believe CCSVI is the cause of MS	I believe CCSVI is the cause of MS Strongly disagree	I believe CCSVI is the cause of MS Disagree	I believe CCSVI is the cause of MS Neutral	I believe CCSVI is the cause of MS Agree	I believe CCSVI is the cause of MS Strongly agree
I believe CCSVI treatment is the cure for MS	I believe CCSVI treatment is the cure for MS Strongly disagree	I believe CCSVI treatment is the cure for MS Disagree	I believe CCSVI treatment is the cure for MS Neutral	I believe CCSVI treatment is the cure for MS Agree	I believe CCSVI treatment is the cure for MS Strongly agree
I believe treatment of CCSVI will halt MS progression	I believe treatment of CCSVI will halt MS progression Strongly disagree	I believe treatment of CCSVI will halt MS progression Disagree	I believe treatment of CCSVI will halt MS progression Neutral	I believe treatment of CCSVI will halt MS progression Agree	I believe treatment of CCSVI will halt MS progression Strongly agree
I believe treatment of CCSVI will reduce MS symptoms	I believe treatment of CCSVI will reduce MS symptoms Strongly disagree	I believe treatment of CCSVI will reduce MS symptoms Disagree	I believe treatment of CCSVI will reduce MS symptoms Neutral	I believe treatment of CCSVI will reduce MS symptoms Agree	I believe treatment of CCSVI will reduce MS symptoms Strongly agree
I believe treatment of CCSVI will reverse MS damage	I believe treatment of CCSVI will reverse MS damage Strongly disagree	I believe treatment of CCSVI will reverse MS damage Disagree	I believe treatment of CCSVI will reverse MS damage Neutral	I believe treatment of CCSVI will reverse MS damage Agree	I believe treatment of CCSVI will reverse MS damage Strongly agree

6. Please answer these questions about CCSVI advocacy:

Please answer these questions about CCSVI advocacy: How many politicians have you contacted about CCSVI?
How many media outlets have you contacted about CCSVI?
How many MS organizations have you contacted about CCSVI?
How many MS clinics or specialists have you contacted about CCSVI?
How many people have you personally told about CCSVI?

7. Please use the following scale to answer the following about the future of CCSVI:

	Least optimistic				Very optimistic
How optimistic are you that the CCSVI theory has been or will be scientifically accepted this year?	*Please use the following scale to answer the following about the future of CCSVI: How optimistic are you that the CCSVI theory has been or will be scientifically accepted this year? Least optimistic	How optimistic are you that the CCSVI theory has been or will be scientifically accepted this year?	How optimistic are you that the CCSVI theory has been or will be scientifically accepted this year?	How optimistic are you that the CCSVI theory has been or will be scientifically accepted this year?	How optimistic are you that the CCSVI theory has been or will be scientifically accepted this year? Very optimistic
How optimistic are you that CCSVI testing will be broadly available within 2 years?	How optimistic are you that CCSVI testing will be broadly available within 2 years? Least optimistic	How optimistic are you that CCSVI testing will be broadly available within 2 years?	How optimistic are you that CCSVI testing will be broadly available within 2 years?	How optimistic are you that CCSVI testing will be broadly available within 2 years?	How optimistic are you that CCSVI testing will be broadly available within 2 years? Very optimistic
How optimistic are you that CCSVI treatment will be broadly available within 5 years?	How optimistic are you that CCSVI treatment will be broadly available within 5 years? Least optimistic	How optimistic are you that CCSVI treatment will be broadly available within 5 years?	How optimistic are you that CCSVI treatment will be broadly available within 5 years?	How optimistic are you that CCSVI treatment will be broadly available within 5 years?	How optimistic are you that CCSVI treatment will be broadly available within 5 years? Very optimistic
How optimistic are you in other therapies and treatments for MS? (add comment below, if you like)	How optimistic are you in other therapies and treatments for MS? (add comment below, if you like) Least optimistic	How optimistic are you in other therapies and treatments for MS? (add comment below, if you like)	How optimistic are you in other therapies and treatments for MS? (add comment below, if you like)	How optimistic are you in other therapies and treatments for MS? (add comment below, if you like)	How optimistic are you in other therapies and treatments for MS? (add comment below, if you like) Very optimistic

Comments:

8. There are over 1000 of us now! What can we do as a group interested in CCSVI and MS?

There are over 1000 of us now! What can we do as a group interested in CCSVI and MS? Are you interested in attending a local gathering of people associated with the CCSVI at UBC and BC MS clinics? (Answer yes / no / maybe)
What location(s) would you be able to attend a gathering? (list all or put "n/a")
What topics would you like to see discussed at a local gathering? (e.g., education about CCSVI or MS, advocacy, fundraising)
Would you like summaries of these gatherings be available online on the Facebook page? (yes / no / maybe)
What other actions and activities do you think we should organize through this Facebook group?
Would you be willing to help with page administration of the Facebook group? (yes / no / maybe)
Would you be willing to help with our Twitter feed that specializes in media stories about CCSVI and MS? (yes / no / maybe)

9. If you want me to contact you, please give me your email address here (I will be the only one who can see it). If you prefer my email address is included at the end of the survey.

If you want me to contact you, please give me your email address here (I will be the only one who can see it). If you prefer my email address is included at the end of the survey.

10. Please add any additional comments you may have about this survey, CCSVI, or MS here. Thank you for completing this survey and make sure to click "Done" to submit! The results will be collected and placed on the CCSVI at UBC page from time to time. To contact me about this survey, email sandra@impact-ltd.ca.

Please add any additional comments you may have about this survey, CCSVI, or MS here. Thank you for completing this survey and make sure to click "Done" to submit! The results will be collected and placed on the CCSVI at UBC page from time to time. To contact me about this survey, email sandra@impact-ltd.ca.

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CCSVI at UBC MS Clinic - Information and Support Facebook SurveyExit this survey

1. Getting to Know You

CCSVI at UBC MS Clinic - Information and Support Facebook Survey
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