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.

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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

January Gift Kitsap Brain Injury Long Sleeve Shirt front

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 Kitsap Brain Injury Long Sleeve Shirt with artwork by Diana Doodles. 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 need the survey in a different format. Contact us

January Gift Kitsap Brain Injury Long Sleeve Shirt back

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