Let us know how you're doing!

The KBF is so happy to be a part of your adventures! We want to hear about how your Active Fund grant has made an impact in your life in the last year.

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* 1. What is your first and last name?
(NOTE: If you are the guardian of the grant recipient, please enter the grant recipient's name.)

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* 2. How long ago did you receive your equipment?
If you received your equipment less than 1 year ago, please hang tight! We would love you to complete this survey once you and your equipment have spent some quality time together!

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* 3. Currently, how often are you physically active (apart from tasks of daily living)?

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* 4. How often do you use the equipment that you were awarded a grant for?

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* 5. (Continued from question 4) If you selected Never or A few times a year, what are the barriers to using your equipment?

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* 6. Overall, how would you rate your physical health?
0=Poor, 10=Excellent

0 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 7. Overall, how would you rate your mental health?
0=Poor, 10=Excellent

0 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 8. Overall, how satisfied are you with life as a whole these days?
0=Not Satisfied at All, 10=Completely Satisfied

0 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 9. In general, how happy or unhappy do you usually feel?
0=Extremely Unhappy, 10=Extremely Happy

0 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 10. I am content with my friendships and relationships.
0=Strongly Disagree, 10=Strongly Agree

0 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 11. I feel as though I am part of a community.
0=Strongly Disagree, 10=Strongly Agree

0 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 12. How often do you worry about being able to meet normal monthly living expenses?
0=Worry All of the Time, 10=Do Not Ever Worry

0 10
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 13. Who do you use your equipment with? (Select all that apply)

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* 14. In one word, what does your Active Fund grant mean to you?

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* 15. Agree or disagree with the following statement: This grant helped inspire and empower me to live an active and engaged life.

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* 16. Agree or disagree with the following statement: Since getting my equipment, I feel better connected to my existing community.

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* 17. Agree or disagree with the following statement: Since getting my equipment, I have developed a sense of belonging within a new community.

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* 18. Agree or disagree with the following statement: Since getting my equipment, my quality of life has improved.

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* 19. Agree or disagree with the following statement: Since getting my equipment, my physical health has improved.

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* 20. Agree or disagree with the following statement: Since getting my equipment, I am able to participate in my sport of choice using equipment that fits me.

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* 21. Agree or disagree with the following statement: Since getting my equipment, I have experienced increased access to and participation within the workforce.

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* 22. Agree or disagree with the following statement: Since getting my equipment, I feel a new sense of freedom.

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* 23. We would love to hear a story, quote, testimonial, or other thought that represents the impact your Active Fund grant has had on the last year of your life! (Optional)

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* 24. Would you be willing to participate in a phone or video interview to help the KBF further measure our impact on the SCI community?

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* 25. Do you have photos or videos of you enjoying your new equipment? (Optional)

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