Questionnaire for Potential Subjects

For interest in participating in Spinal Cord Injury research please click on this link to fill out the intake survey

For all other research interests, including stroke, acquired brain injury, or MS please fill out the form below:

If SCI, please indicate which of the following best describes you:

If ABI, what best describes you:

If MS, please indicate what form of MS you have:

Do you have any other significant medical issues or other diagnoses that we should be aware of, such as high blood pressure, diabetes, cardiac pacemaker, stroke, cardiac disease, skin breakdown, etc.?

Is there a specific area of research that you are interested in, such as drug studies, device studies, cellular studies vs. curative studies or therapy intervention studies?

If you checked "Yes," please tell us what areas of research you are interested in: