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* 1. If you have a diagnosis, please name your chronic pain condition(s) here:

* 2. What is your biggest challenge when it comes to managing your pain and illness?

* 3. What are your biggest frustrations?

* 4. Which of the following pain management techniques would you like to learn more about?

  Not interested Maybe interested Definitely, I would love that!
Using pacing for pain management
How to increase my mobility
Managing severe pain during a flare-up or set-back
Using pain psychology and tools to cope with the emotional side of living in pain
Natural pain-relief techniques
Quick tips that I can print out, learn, and benefit from instantly
A combination of the above

* 5. Which of the following tips would benefit you most (tick as many as apply)?

* 6. What are your favourite kind of posts?

* 7. What guide/product/service do you wish someone would create to help you manage living with chronic pain and illness?

* 8. Would you be interested in any of the following?

  Not interested Maybe interested Yes, if it is free or good value Definitely, I would love that!
Downloadable PDFs
Information sheets to print out and share with loved-ones
A mini online pain management course
A series of ebooks
A package of PDFs, ebook, coping guides, and videos on pain management & living well with pain

* 9. What's your best coping or pain management tip, or the one thing you are never without (to manage your pain)?

♥ Thank you, I appreciate your help and support ♥

<div style="text-align: center;"><span style="font-size: 18pt; color: #56c495;"><strong>♥ Thank you, I appreciate your help and support ♥</strong></span></div>

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