2020 Brain & Spinal Cord Injury Advisory Council Survivor Survey Question Title * 1. I live in (city/county): OK Question Title * 2. I am currently living (check all that apply): With Family Own home Apartment Subsidized housing Group home Assisted living facility OK Question Title * 3. It was difficult for me to find a place to live after I left the hospital: Yes No If you answered YES to question 3, please answer question 4; if you answered NO, please proceed to question 5. OK Question Title * 4. The reason it was so difficult for me to find a place to live after I left the hospital is: I didn’t know how to find a place to live there were no accessible housing opportunities nothing available for me too expensive; didn’t have the money no one would help me If Other (please specify) OK Question Title * 5. In what year was your injury? OK Question Title * 6. My injury can be described as (check one): Closed-head Open-head Birth defect OK Question Title * 7. The cause of my injury was: Abuse Assault ATV Auto Fall Gun Motorcycle Near Drowning Pedestrian Accident Sports related Substance Abuse Disorder/Opioid Overdose OK Question Title * 8. The severity of my injury can be described Severe Moderate Mild OK Question Title * 9. I understand what my brain injury is and how it has affected me: Yes No OK Question Title * 10. I feel that I was well informed of my injury by the healthcare professionals. Strongly agree Agree Disagree Strongly disagree OK Question Title * 11. The person(s) who helped me understand what my injury means are (check all that apply): my doctor nurse family member I researched myself Other (please specify) OK Question Title * 12. I have healthcare through: Medicare Medicaid Private Insurance Personal Payment Other (please specify) OK Question Title * 13. My insurance covers most of my healthcare costs/needs: Yes No OK Question Title * 14. Were you contacted or offered any help or support from any agency following your injury? Yes No If Yes, please provide the name of the agency. OK Question Title * 15. Would it have been helpful if somebody contacted you to help you to get back in the community? Yes No OK Question Title * 16. Since my injury I have been able to get what I need as a survivor: Yes No If you answered NO, please list what your unmet needs are: OK Question Title * 17. The services I am receiving/have received while living in the community are (check all that apply): Assistive Technology Day Program Employment Services Home Environmental Modifications I am not/have not received services since my injury Mental Health Counseling Occupational Therapy Personal Care Attendants Personal Care Providers Physical Therapy Respite Speech Therapy Support Groups OK Question Title * 18. I am satisfied with my services. Yes No OK Question Title * 19. Those who provide support to me/assist in everyday activities (check all that apply): spouse/partner family/friend nurse personal care assistant OK Question Title * 20. After I had my injury, I was able to get resources to help me financially through (check all that apply): Internet BIANH Information from hospital Family/Friend Case Manager Other (please specify) OK Question Title * 21. I am able to do the following activities by myself (check all that apply): Dressing Grooming Bathing/Hygiene Toileting/Using the Bathroom Meal Preparation/Shopping OK Question Title * 22. For those activities listed in question 21, do you receive any assistance to help you perform these activities? Yes No OK Question Title * 23. I feel that my injury has affected my relationships with friends/family. Strongly agree Agree Disagree Strongly disagree OK Question Title * 24. My relationships have improved because I have (check all that apply): A better understanding of my injury Educated/informed from medical professionals Spouse/Partner/Family/Friends have been educated Support Staff Other (please specify) OK Question Title * 25. Before COVID-19, did you experience any isolation? Yes No OK Question Title * 26. I can get from one place to another by: Driving myself Taxi/Uber Public transportation Family/Friends Other (please specify) OK Question Title * 27. Finding transportation is a difficult thing for me to do: Strongly agree Agree Disagree Strongly disagree OK Question Title * 28. I am currently employed: Yes No If you answered No to question 28, answer question 29, otherwise skip to question 30. OK Question Title * 29. Do you want a job? Yes No OK Question Title * 30. Please share additional comments that you feel are important for us to know. OK Question Title * 31. Has anyone helped you to fill out this survey? Yes No If so, what is their relationship to you? OK DONE