Here you go.
>Hello to all:
>
>Back on 8/10 I posted a brief questionnaire at the suggestion
>of Sayward. I have completed tallying the data from the 43
>folks that responded. If you misplaced the original questionnaire,
>are new or just didn't have time at that time I'm posting it again
>below. Thanks for your help from all fellow TMers.
>
>__________________________________________________
>
>I will collate this data and I will not release any of it on any
>individual unless given permission. The geography questions
>are related to MS research. I would ask that everyone, visitors,
>just readers, helpers etc., to complete the questionnaire if it
>applies to you, family members or friends with a Dx of
>Transverse Myelitis. Hopefully we can make a difference.
>
>1. NAME: (optional) GENDER:
>
>2. DATE OF Dx: LOCATION: (City,State)
>
>3. AGE AT dx: LOCATION: (City, State)
>
>4. CURRENT AGE: LOCATION: (City, State)
>
>5. BIRTH LOCATION: (City, State)
>
>6. UNUSUAL CIRCUMSTANCES: (Lived in one place, Dx'd in
> another location. There were a few subscribers who were on
> vacation or business).
>
>7. CURRENT MEDICATIONS: (Please List)
>
>8. MEDICATIONS TRIED BUT DID NOT WORK FOR YOU (Please list)
>
>9. IF YOU FEEL THAT YOUR PHYSICIAN/NEUROLOGIST IS
> EXPERIENCED WITH TM (or atleast willing to learn) PLEASE
> LIST HIM AS SOMEONE YOU WOULD RECOMMEND TO OTHERS:
>
> NAME:
> SPECIALTY:
> HOSPITAL AFFILIATION:
> CITY, STATE:
> TELEPHONE:
>
>10. IF YOU HAVE BEEN TREATED BY A PHYSICIAN/NEUROLOGIST
> THAT SHOULD BE AVOIDED AT ALL COSTS BY THOSE WITH TM.
>
> NAME:
> SPECIALTY:
> HOSPITAL AFFILIATION:
> CITY, STATE:
> TELEPHONE:
>
>I hope this information will aide many.
>
>
>Doc
>