About You

These questions will tell us a little bit about you.  Please answer honestly.  Your answers are confidential and are very important to us.

What is your age?

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* 1. What is your age?

What is your gender?

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* 2. What is your gender?

What degree of ABI (acquired brain injury) does your loved one have?

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* 3. What degree of ABI (acquired brain injury) does your loved one have?

What was the cause of the brain injury?

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* 4. What was the cause of the brain injury?

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