First of all, thank you for your interest in being part of the focus group for people who stammer. Please fill in the form below to apply.

Question Title

* 1. What's your name?

Question Title

* 2. How old are you?

Question Title

* 3. What is your email address?

Question Title

* 4. Where do you live?

Question Title

* 5. How do you feel about stammering?

I hate it I love it
Clear
i We adjusted the number you entered based on the slider’s scale.

Question Title

* 6. Have you had speech therapy for stammering in the last 5 years?

T