National Dysphagia Awareness Month (awareness idea collection)

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* 1. What category best describes you? Please select all that apply. (Optional)

Someone who suffers from a swallowing disorder

A spouse/family member/friend caring for someone with a swallowing disorder

A speech-language pathologist

A physician who cares for someone with a swallowing disorder

A student learning to care for those with a swallowing disorder

Other (please specify)

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* 2. Please tell us your idea...

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* 3. If you suffer from a swallowing disorder or are a spouse/friend caring for someone with a swallowing disorder and would like to share the impact this has on you on our "Community Forum," please enter your comment below. All responses will be posted anonymously.

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* 4. US Residents -- Name (First, Last) and Email Address (Optional)

First name:

Last name:

Email Address:

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* 5. Non US Residents -- Name (First, Last), Country, and Email Address (Optional)

First name:

Last name:

Country:

Email Address: