Demographics Form — SitGrit

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Folder: CONTACT

SitGrit Demographics Survey

Disclaimer: All information given in this form is completely anonymous. This information will be used to design SitGrit for all who register!

Please enter your date of birth

MM

DD

YYYY

Gender

Male

Female

Non-binary

Prefer not to say

Other

Do you have any of the following?

Spinal Cord Injury

Multiple Sclerosis

Parkinson's

None

Other

Anything else you'd like to share with us?

Thank you!

SitGrit