Your Opinion Matters

We'd like to hear from you. Tell us how we can provide you with the information and service you need the most. If you would take a moment to complete, we sure would appreciate your input. This information will remain confidential and used specifically for the purpose of creating better communication and awareness for the CRPS/RSD community.

 
1.

Are you a

CRPS/RSD Patient
Caregiver
Physician
Researcher
Family Member
Friend
Parent answering for child with CRPS/RSD
Other  
2.

If you are a patient, how long ago were you diagnosed?

Less than one year
1-5 years
5-10 years
more than 10 years
3.

Did your Doctor diagnose you with

CRPS
RSD
4.

What kind of Doctor diagnosed you?

 

50 characters left.
5.

Would you be interested in participating in a RSDSA Research Study?

Yes
No
6.

If so, would you like to receive further information on participating?

Yes
No
  • Comment:

  • 500 characters left.
7.

Are you a member of the RSDSA?

Yes
No
8.

If you are not a member, would you like to receive further information on becoming a member? 

Yes
No
9.

Are you a member of a CRPS/RSD support group?

Yes
No
10.

If so, what type of support group do you belong? Can you tell us the location and which online groups you visit or are a member?

Online
In Person
Both
  • Comment:

  • 500 characters left.
11.

Please select your age range:

under 18
19-25
26-30
31-40
41-50
over 50
12.

Gender:

Male
Female
13.

Where do you find information on CRPS/RSD? (please select all that apply)

RSDSA Review Newsletter
RSDSA website
Doctor's Office
Books, Magazines
Social Media (Facebook, Twitter, LinkedIn)
other websites (please specify)
Other  
14.

Do you currently receive the RSDSA Review newsletter?

Yes
No
15.

If not, would you like to receive in the future?

Yes
No
16.

How would you prefer to receive the RSDSA Review?

Mail
Email
Both
17.

If you wish to receive the RSDSA Review Newsletter, please include your address below.


By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

18.

Which articles do you find of interest in the RSDSA Review?

Patient interviews/stories
Treatment
Fundraising activities
Science and research
Other  
19.

What Newsletter information/articles would interest you?
(select all that apply)

"How to" articles that offer practical advice
Medical updates and research
News on Support Groups around the country
"Stories of Hope" from other people who have CRPS
Stories from caregivers
Stories on groups who are raising awareness or doing fundraising
Legislative updates
Other  
20.

Which of the following RSDSA cards/brochures have you received (or downloaded from website)?

Recognizing, Understanding, and Treating CRPS
I Have CRPS
Take Flight With Hope (stories of Hope)
Helping Children Succeed in School
Treating CRPS
In Pain, Out of Work, and Agonizing Over the Bills (resource directory)
Other  
21.

Is this the best email address to send you RSDSA news? (If not, please enter new email address in the comment section)

Yes
No
  • Comment:

  • 500 characters left.
22.

Have you visited the RSDSA website?

 

Yes
No
23.

If so, would you please rate the following attributes of the RSDSA website?

 Excellent Good Fair Poor  
Ease of navigation  
Freshness of content  
Accuracy of information  
Layout/design  
Meeting your needs  
  • Comment:

  • 500 characters left.
24.

What more can the RSDSA newsletter or website do to help you and the CRPS/RSD community?

 

350 characters left.

Thank you for helping us build a stronger CRPS/RSD community. Together we can make a difference. If you have any questions, please call us toll free:
877-662-7737 or email us at newsletter@rsds.org.