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Balance Awareness Week (BAW) Activity Survey
Balance Awareness Week (BAW) Activity Survey
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*
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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:
Use the plus sign on the right to add fields.
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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.
Add
Remove
Links to your social media posts or other outreach:
Use the plus sign on the right to add fields.
Add
Remove
Photo(s) of you participating in BAW:
Drop files here or
Select files
Max. file size: 128 MB.
Why did you choose to participate in Balance Awareness Week?
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