Please complete our 5-minute survey. Please tell us about yourself. Question Title * 1. Select all that apply to you: Individual with brain injury Family member of an individual with a brain injury Provider of professional services to people with brain injury Brain injury support group leader or participant Other (please specify) Question Title * 2. Your zip code: Question Title * 3. Please indicate your race/ethnicity. White Hispanic/Latino Black or African-American Native American or American Indian Asian/Pacific Islander Other (please specify) Question Title * 4. How did you hear about the Brain Injury Alliance of Connecticut (BIAC)? Website Mailings Friend or family member Professional networks Attending a BIAC event (e.g. Walk for Thought) Hospital/doctor recommendation Other (please specify) Question Title * 5. Are you aware that the Brain Injury Alliance of Connecticut (BIAC) has a HelpLine staffed by certified Brain Injury Specialists who provide individual support and guidance? Yes No We are seeking to improve the services and programs offered by the Brain Injury Alliance of Connecticut. Select your level of interest for each item in questions 6-12. Question Title * 6. SUPPORT GROUP for brain injury survivors conducted ONLINE: Very interested Somewhat interested Neutral Not very interested Not at all interested Question Title * 7. LIVE WEBINARS on brain injury topics conducted by experienced professionals: Very interested Somewhat interested Neutral Not very interested Not at all interested Question Title * 8. Occasional TEXT MESSAGES for reminders of events, trainings, and support groups hosted by the Brain Injury Alliance of Connecticut: Very interested Somewhat interested Neutral Not very interested Not at all interested Question Title * 9. "Ask the expert" LIVE ONLINE WEB CHATS with Connecticut-based experts about brain injury issues and resources: Very interested Somewhat interested Neutral Not very interested Not at all interested Question Title * 10. IN-PERSON TRAINING conducted by Brain Injury Alliance of Connecticut staff members in your class, workplace, or organization: Very interested Somewhat interested Neutral Not very interested Not at all interested Question Title * 11. "ON-DEMAND" online training by state or national experts (Fee-based with CEUs offered): Very interested Somewhat interested Neutral Not very interested Not at all interested Question Title * 12. I would like more resources, programs, or training on the following topics. Check all that apply. Introduction to brain injury Concussion Accessing brain injury services/resources in another language Pediatric brain injury (services and supports) Intimate partner violence and brain injury Returning to the classroom after a brain injury/concussion ("return to learn") Returning to play/sports after brain injury/concussion Returning to work after brain injury Social and recreational opportunities for individuals with brain injury Assistive technology for individuals with brain injury Psychopharmacology after brain injury Life care planning after brain injury (e.g. trust funds, conservatorship) Prevention of brain injury Legislation in Connecticut affecting individuals with brain injury, families, or providers Understanding disability benefits Americans with Disabilities Act Legal issues related to brain injury Compensatory strategies for optimal independence within the community Accessing community-based services in Connecticut Support for caregivers Other (please specify) Question Title * 13. If you would like access to brain injury services/resources in another language, please specify the language(s) below: Question Title * 14. I would be interested in a support group in my area. No Yes (please specify area) Question Title * 15. (Optional) Provide your contact information if you would like us to follow up with you. Name Organization Email Address Phone Number Question Title * 16. Tell us how BIAC can more effectively provide assistance to you or your community. Submit