Service Needs Questionnaire for Traumatic Brain Injury Survivors in North Carolina

We need your help to identify gaps in services for people with a Traumatic Brain Injury living in North Carolina. 

Traumatic brain injury, or TBI for short, is an injury to the brain that happened sometime after birth, when the head hits a stationary object, or is hit, penetrated, or violently shaken by some external force.

The purpose to this survey is to achieve a better understanding of whether individuals with TBI have been able to access services related to their TBI and what service gaps exist.

This survey is anonymous.

If you are filling out this survey on behalf of someone with a TBI, please answer the questions from the point of view of the person with the TBI.
1.What date (month/year) was your TBI diagnosed?(Required.)
2.What county do you live in?(Required.)
3.Are you a veteran?(Required.)
4.What is your age?(Required.)
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