Balance Awareness Week (BAW) Activity Survey - Vestibular Disorders Association

Name*

First Last

Email*

Phone

I am a:*

Vestibular Patient

Friend/Family of a Vestibular Patient

Vestibular Healthcare Professional

Activities you have participated in so far:

Prominently displayed the Balance Awareness Week poster in my clinic.

Organized a free balance screening.

Presented an informational webinar or other educational event.

Decorated our clinic with flamingos!

Shared VeDA's educational posts on social media.

Shared the Life Rebalanced Chronicles docu-series videos on social media.

Participated in the Fiona Flamingo Photo Contest.

Purchased VeDA branded merchandise.

Other

List of other activities:

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Activities you have participated in so far:

Created a peer-to-peer fundraising page.

Shared VeDA's educational posts on social media.

Shared the Life Rebalanced Chronicles docu-series videos on social media.

Participated in the Fiona Flamingo Photo Contest.

Purchased VeDA branded merchandise.

Other

List of other activities:

Use the plus sign on the right to add fields.

Links to your social media posts or other outreach:

Use the plus sign on the right to add fields.

Photo(s) of you participating in BAW:

Drop files here or

Max. file size: 128 MB.

Why did you choose to participate in Balance Awareness Week?