100%
Time and Stroke Outcome
Questions marked with a
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are required
Hello:
Welcome to this short survey. It will take about five minutes to complete. A stroke affected or his/her family caregiver aware of circumstances in which stroke happened may participate. "You" here is primarily meant for the stroke affected, per context.
Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact Stroke Support India at
strokeindia@gmail.com
.
Aggregate Results of this survey may be reported in our Groups, Website , Social Media channels and other publications.If you wish to join our Stroke Support Groups please see :
https://strokesupport.in/add/
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue/ Next Question
button below.
Did you receive timely treatment when stroke happened to you ?
Help Tip
Did you receive timely treatment when stroke happened to you ?
No
Yes
If the answer to above question is "No" how, in your opinion, the delay effected you ?
Help Tip
If the answer to above question is "No" how, in your opinion, the delay effected you ?
No effect
Worse outcome
Better Outcome
Not Applicable
In which country and city did you suffer the stroke ?
Were you aware stroke was happening when it occurred to you ?
Were you aware stroke was happening when it occurred to you ?
No
Yes
Somewhat Aware
What was your approximate age ( in completed years) when stroke happened to you ?
What type of stroke did you suffer ?
What type of stroke did you suffer ?
-- Select --
Ischemic
Hemorrhagic
Don't Know
Other
What is your gender ?
What is your gender ?
-- Select --
Female
Male
Prefer not to say
Comments/Suggestions you wish to give (optional):
If you wish to be contacted further on this Survey, please leave your contact information here. (optional)
First Name
Last Name
Phone
Email Address
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