News Newsletter Disease Testimonials Organization The tale Contact Enquête Anonyme Livre d'or

A brief survey

 

Thank you for answering a few questions. These are general questions, and this survey is anonymous, except if you accept to let us know your e-mail address so we can contact you. We give nobody our visitors’ e-mail addresses.

Your answers are very important to us: they allow us to get a more accurate idea of what our visitors are and why they come and visit our Web site. Thank you for helping us.



Geographical data

   

Demographics

 

Your relationship with the handicap issue

  •  Are you a health professional?
       

    If so, you are a: 

    Feel free to specify any useful detail:


  •  Are you concerned by the handicap issue in your private life?
       

    If so, can you tell us more: 


  •  Have you already heard of SSPE?
       

    If so, can you tell us how? 


How did you discover L’Oiseau Bleu (The Blue Bird)?

  •  How did you hear of L’Oiseau Bleu (The Blue Bird)? 


    Feel free to specify any useful detail:


  •  If you found us through the Internet, thanks to let us know more precisely how:


Your e-mail address

  •  E-mail: 

    By letting us know your e-mail address, you authorize L’Oiseau Bleu (The Blue Bird) to communicate with you using this address.
    Your address will be disclosed to nobody.