Cope with MS Study Intake Form

Cope with MS Study Intake Form

Cope With MS Study

Thank you for your interest in our study! This study has currently ended, but if you would like to be added to our contact list for future studies, please feel free to fill out the form below and we will get you added to our list! 

This study is examining the relationship between religiosity/spirituality and coping behavior with multiple sclerosis. We will ask you to complete several short surveys which should take about 45 minutes to complete. We will mail you a packet of surveys for you to complete at your own pace within one week. We will also send a self-addressed return envelope with postage in the mailed surveys. You will be compensated with a $20 gift card for your time and effort in completing the surveys.  

 

 

answer must be an email address

 

answer must be phone number with area code like 217-333-1000

 

 

 

 

answer must be a zipcode like 61864 or 61864-8180

 

answer must be numeric

 

answer must be numeric

 

required11. What type of MS were you diagnosed with?

required11. What type of MS were you diagnosed with?

required12. Which is your preferred method of contact?

required12. Which is your preferred method of contact?

required13. Are you bedridden (cannot sit in a wheelchair for more than an hour)?

required13. Are you bedridden (cannot sit in a wheelchair for more than an hour)?

 

15. Which gift card would you prefer?

15. Which gift card would you prefer?

16. While most participants prefer the paper copy of the survey mailed to them, however we do offer an online version of the survey. Would you prefer the paper version mailed or the online version via email?

16. While most participants prefer the paper copy of the survey mailed to them, however we do offer an online version of the survey. Would you prefer the paper version mailed or the online version via email?

17. How did you hear about our study?

17. How did you hear about our study?

Thank you!

Thank you for completing our survey and your interest in participating in our research study! Once you hit the submit button below, we will contact you using your preferred method as soon as possible to let you know if you qualify for our study!