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In order to register, we ask you to fill in your name, e-mail address and country and choose a password (the boxes marked with an asterisk). However, any additional information you are able to give us in the optional questionnaire will help us to develop this site so that it can continue to reflect the needs and interests of its visitors.

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1. Are you? Male Female

2. Which of the following statements best describes your reason for visiting this site:

I am interested in MS
I have had MS for some time now
I have had MS for some time now and have just started taking BETAFERON®
I have just been diagnosed with MS
I have just been diagnosed with MS and am taking BETAFERON®
I help someone with MS at home
I know someone with MS
I think I have MS but have not been formally diagnosed
I treat people with MS
Not given
Other

If other please specify:

3. What is your age group?

18 or under
19-30
31-39
40-49
50-59
60-69
70+
Not given

4. Until now, where have you found your information on MS?

Friends and family
Medical journals
MS society
MS support groups/charities
My doctor
Newspaper/media
Textbooks
The Web

5. What is your employment status?

A homemaker/housewife/husband
A student
A volunteer
Employed
not given
Retired

6. If you are employed or retired, what is or was your occupation? Please select the category which most closely describes your occupation.

If other please specify:

7. How long has it been since you were diagnosed with MS?

Not given
11+ years
5-10 years ago
1-4 years ago
less than 1 year
I do not have MS

8. Do you visit MS-related Web sites regularly?

Yes No

9. Have you used our links to visit other sites?

Yes No

Thank you for completing the form. We'd very much like to hear your comments/suggestions on this site. If there is anything you would like to tell us, please fill in your comments below. Please remember to include your name, email address and country of origin in order to receive relevant information in your local language where possible.

 

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