Your Injury Experience
Thanks for your interest! I really appreciate you taking the time to share your injury experience.

Many people that find themselves injured (be it through broken bones, torn ligaments, burns or wounds) and struggling to cope with the major changes to their lives. Many people may be getting great medical treatment, but perhaps not the broader (eg. emotional, practical) support they want.

I create resources and products to help people through their injury; so they can gain positive outcomes. Please share what you are experiencing and feel free to ask any questions.

Please indicate if you would like to be quoted or acknowledged in anything that comes next. Contact details will be kept confidential. If you have any questions please email me at 
Sign in to Google to save your progress. Learn more
Email *
1. What kind of injury did you suffer?
2. How well do you think you coped with the injury overall (including physical, mental and emotional aspects)?
Not well at all
Extremely well
Clear selection
3. Please choose which aspect/s you found the most difficult to cope with
4. Are there any impacts you'd like to talk about in more detail?
5. What strategies did you use to get through the challenges?
Please describe. For example: meditation, spending time with friends, getting on with life, working on your mindset, watching movies, caring for others, painting etc.
6. If you could have had more help or support, what would have been beneficial?
This is your opportunity to tell me what you really, really needed. For example, would it have been information, access to an online group where you could connect with others, access to a counsellor, or anything else? Please be as open and frank as possible!
7. Where would you go looking to find information or help if you wanted it?
Choose as many as apply
8. Would you have paid to access a support group / product / experts or would you have expected free support?
Check all that apply
9. Do you want to add any other thoughts or opinions?
10. If you would like to be quoted and/or acknowledged please leave your preference and name here
(I will do my best to acknowledge people where appropriate)
11. Which country are you from?
Thanks very much for completing the survey! If you'd be interested in a follow up phone call to discuss in more detail or would like to be contacted as the project progresses, please leave your email address and I will get in touch.
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy