Thank you for taking the time to complete our questionnaire. Your participation will help us to "END THE SILENCE". Please read this page carefully, it contains information and helpful hints to make your participation an easy experience.
There are required questions which must be answered, or your answers will not be accepted. They are marked with an * . The questionnaire asks for information which you may need to look up, such as the name and dosages of medications. If it is necessary for you to locate information, the best thing to do is save the answers you have already filled in by scrolling down to the bottom of the screen and click on the "Modify" button. You will be able to resume filling out the remainder of the information by using the "Return to Previous Page" link on the resulting screen, or, if you should need to come back later, use link #2 below to log-in. You can also use that link to return and continue with the questionnaire, should you need to. You will find, Save your work now in a number of locations in the survey. By clicking on these links, it will take you to the bottom of the page. Use the Modify button to save your work then return to the survey