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National MPS Society Partnership Program: Rarely Defined
Partnership program for individuals 12 years of age and older diagnosed with MPS or ML
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Email
*
Your email
Name
Your answer
Age
Your answer
Phone Number
*
Your answer
Gender
Male
Female
Non-binary
Prefer not to disclose
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I am filling out this survey:
On behalf of myself
On behalf of an adult with MPS or ML
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Are you looking to receive support from someone else to share your experiences to provide support to others?
Receive support
Provide support
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What type of MPS or ML do you have?
Your answer
Would you prefer to be paired with someone that has the same syndrome type?
Yes
No
Clear selection
What topics would you like to discuss?
Managing MPS or ML
School/Friends/Peers
Discussing MPS or ML with friends/others who may not know about it
College/Work
Transitioning into adulthood
Other:
Are you looking for emotional support or educational resources?
Emotional Support
Educational Resources
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What do you hope to get our of a partnership program?
Connecting with another person with MPS or ML who understands the journey
Giving or receiving advice on MPS or ML
Other:
How often would you like to connect with your partner?
Weekly
Twice a month
Once a month
As needed
Other:
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Time Zone
ET
CT
MT
PT
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Are you a member of the National MPS Society?
Yes
No
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What is your preferred method of communication?
Email
Phone Call
Text
Other:
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