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* 3. LANGUAGE(S) FLUENTLY SPOKEN (Select all that apply AND press OK when finished)

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* 10. WHICH OF THE FOLLOWING BENEFITS ARE YOU CURRENTLY RECEIVING? (Select all that apply AND press OK when finished)

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* 12. DO YOU ATTEND A SPINAL CORD INJURY SUPPORT GROUP IN YOUR AREA?  (Please select one AND press OK when finished)

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* 13. BASED ON HOW YOU RESPONDED TO QUESTION #12, WE CAN PROVIDE SOME INFORMATION ABOUT SCI SUPPORT GROUPS LOCATED CLOSEST TO YOU.  IF YOU WOULD LIKE TO RECEIVE SUCH INFORMATION, PLEASE PROVIDE THE FOLLOWING ABOUT YOURSELF.

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* 14. RATE YOUR LEVEL OF ENGAGEMENT WITH SOCIAL MEDIA SITES.

  USE IT ALL THE TIME USE IT OFTEN USE IT PERIODICALLY DON'T USE IT VERY OFTEN NEVER USE IT NOT APPLICABLE
Facebook
Twitter
Instagram
Snapchat
LinkedIn
Tumblr
Youtube
Flickr
Reddit
Pinterest
Kik
Vimeo

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* 17. RATE YOUR LEVEL OF INTEREST IN THE FOLLOWING TOPICS AS THEY RELATE TO YOUR CONDITION/NEEDS.  (Please make a selection for each topic AND press OK when finished)

  EXTREMELY INTERESTED FAIRLY INTERESTED SOMEWHAT INTERESTED LIGHTLY INTERESTED NOT INTERESTED AT ALL NOT APPLICABLE
Acute SCI (newly injured, less than three years)
Advocacy
Alternative therapy (such as acupuncture, yoga, pilates)
Bowel & Bladder
Caregiving
Chronic SCI (long time with SCI, more than three years)
Computers/Technology
Employment
Equipment
Exercise
Family Relationships
Diet & Nutrition
Funding
Hobbies (such as photography, dancing, art, cooking)
Housing
Legislation
Medications used to treat various SCI-related symptoms
Mentoring
Pain Management
Public education/speaking
Recreation
Relationships, Dating & Sexuality
School
SCI research/innovative treatment/clinical trials
Sports (participating in such activities)
Travel
Women – topics of interest to females

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* 18. WHAT ARE SOME OF THE ISSUES THAT CHALLENGE YOU? (Select all that apply AND press OK when finished)

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