More Than Walking - Help Request
At More Than Walking, we do our best to connect those who need various forms of community support with established local organizations and peer mentors within our network. More Than Walking Incorporated does not provide direct financial support, but can refer you to other organizations that can. Please name specific mentors, if you are responding to a published video with a question, as we will forward your message and e-mail that person so they can respond, either directly or forwarded through mentors@morethanwalking.com.
Email address *
What is the best way to contact you? *
Salutation
Your First Name *
Your answer
Your last name *
Your answer
Your birthdate *
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Your relationship to person needing support *
Name or Initials of person needing support (if not you)
Your answer
Age range of person needing support (if not you)
Specific spinal cord injury level or disability *
Your answer
Spinal cord injury type
Description of function and sensation
Your answer
Approximate date of injury / disability *
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Hospitals where person needing support has been treated for their disability
Your answer
What support is needed / What message would you like forwarded? *
Your answer
Your phone number (xxx) xxx-xxxx *
Your answer
Street Address
Your answer
City *
Your answer
State / Province *
Your answer
Postal Code
Your answer
Country *
Your answer
Disclaimer
​More Than Walking Incorporated does not certify peer mentors and does not conduct background checks on those who volunteer to share stories on videos it produces. None of the information provided in More Than Walking's communications with you should be considered medical advice. You communicate with More Than Walking's mentor contacts at your own risk and discretion. By submitting the form below, you give us permission to contact you regarding your request, share details of your request and your contact information to partnered advocacy organizations in your area, and add you to our e-mail newsletter. ​
I am over 18 years old and I acknowledge the above disclaimer. *
A copy of your responses will be emailed to the address you provided.
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