Meet & Greet

1

Name* This field is required.

First Name

Last Name

2

E-mail* This field is required.I promise to not spam you!

3

What is your age? Gender?

4

What type of MS do you have & how long have you had MS for?

5

Do you use an assistive device?(i.e. cane, crutches, walker, collator, etc.)

Yes, always

Yes, sometimes

No, never

Other

6

What MS symptoms do you suffer from?* This field is required.

7

What is your biggest challenge & why?

8

What topics would you like to learn more about regarding Multiple Sclerosis?(i.e. the disease, types of MS, MS progression, specific symptom management, nutrition, anything!)

9

What types of things would make your life easier?(i.e. a foot/ankle brace, grocery delivery, a personal driver, easy recipes, anything! It doesn't have to be related to MS)

10

What hobbies do you have?

11

If you went on a shopping spree, where would you go & what would you buy?!

12

What does a typical day look like for you?

13

What would a successful/productive day look like for you & why?

14

Are you working? If so, do you work from an office or at home? If not, is it due to your MS symptoms?

15

If you were to go on YouTube, what types of things would you search for?

16

Describe a recent purchase. Why did you consider this purchase, what was the evaluation process, and how did you decide to purchase that product or service?(This could be something as small as a pair of socks, something as big as a car, or anything in-between!)

17

What is your preferred method of communication - social media? email? blogs? telephone? video calls (i.e. Skype)