Join research study

Join Stroke Rehab study

Please answer all the questions to join this research study. Your answers are kept confidential and will not be shared with anyone except the research team.
1. Name*

First NameLast Name
Preferred method of contact:

EmailPhone
2. Email:*
example@example.com
Your phone number will only be used by the research team to contact you in case you are eligible to participate.
3. Phone Number:*

Area CodePhone Number
4. Age*
in years
5. When did you have your latest stroke?*

YearMonthDay
year - month -day
6. Is one or both of your legs weaker than normal, following a stroke? (Lower Extremity Hemiparesis)*

YesNo
7. Can you attend 2 online meetings (60-90 minutes each) per week for this study? A computer with internet can be provided for you.*

YesNo
8. Please check if any of the following are true for you:*

I live in a long-term care facility.I have severe vision or hearing loss.My legs are affected by another condition that impacts their function. (For example Amputation, a musculoskeletal or neurological condition, etc).None of the above.
9. The TRAIL clinical trial currently has active sites in British Columbia, Manitoba, Ontario and Nova Scotia. Please select in which of these provinces you reside*

British ColumbiaManitobaOntarioNova ScotiaOther
Result*
source
area
Wayturn contact email
Should be Empty:

Join Stroke Rehab study