A stipulation of our grants is we are to provide evidence every quarter that our groups improve the quality of life for brain injury survivors. We have identified that utilizing self-reported quality-of-life surveys is the ideal mechanism to capture the required evidence. Only brain injury survivors should participate in this wellness survey. Much of this survey was extracted from the QOLBRI survey which can be found here.

HIPAA compliane logo

To conduct this survey, we are using EmailMeForm (EMF) due to their HIPAA Compliance. EmailMeForm will tally and report the survey results. The quarterly results will be available on our website toward the end of March. You can learn more about EmailMeForm here

A $15 Amazon gift card to help with you Holidays

By completing this anonymous survey, you are supporting Kitsap Brain Injury. To show our appreciation for completing the quarterly survey, we will send you a gift. This quarter's gift is a $15 Amazon gift card. We are hoping it helps to help with Holiday expenses and reduces some Holiday stress. To receive the gift, you must input your email address before submitting the form. Once we receive a notification of form completion, we will email you to verify your shipping address.

If you have trouble completing the survey online. Let us know and we will mail you a paper survey with a addressed and stamped return envelope.Contact us

This survey is intended for the Kitsap Brain Injury community. Anyone can complete the survey but only verfied members will recieve the gift. There is only one gift per person. We hope everyone takes their time doing the survey and answer each question honestly.

Note: this online survey was intended for use with desktops or laptops only.