Restart

Thank you for taking the time to provide feedback for our "Re-start" program at the Brain Injury Association of Waterloo Wellington. Your feedback is important to us!

What relationship do you have with brain injuries? (Select all that apply)

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* 1. What relationship do you have with brain injuries? (Select all that apply)

How many years have you been active in the ABI field (since your Acquired Brain Injury or starting your profession)?

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* 2. How many years have you been active in the ABI field (since your Acquired Brain Injury or starting your profession)?

What area do you live or work in?

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* 3. What area do you live or work in?

What services or programs do you want to see (re)established for the Waterloo –Wellington areas? (select up to five)

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* 4. What services or programs do you want to see (re)established for the Waterloo –Wellington areas? (select up to five)

As we “restart” our organization, what do you think is the most pressing need for our communities?

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* 5. As we “restart” our organization, what do you think is the most pressing need for our communities?

What roles would you be interested in participating in?  (select all that apply)

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* 6. What roles would you be interested in participating in?  (select all that apply)

Have you been involved in the BIAWW in the past? If so, please indicate in what capacity. Why are you no longer involved in BIAWW?

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* 7. Have you been involved in the BIAWW in the past? If so, please indicate in what capacity. Why are you no longer involved in BIAWW?

Are you a current member of the BIAWW? (Through BIAWW or through dual memberships at OBIA)

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* 8. Are you a current member of the BIAWW? (Through BIAWW or through dual memberships at OBIA)

Contact Information (Optional – but necessary for us to contact you for membership and participation roles)

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* 9. Contact Information (Optional – but necessary for us to contact you for membership and participation roles)

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