Question Title

* 1. What is your age?

Question Title

* 2. Are you male or female

Question Title

* 3. Do you have Crohn's or Colitis?

Question Title

* 4. Have you had surgery?

Question Title

* 5. Do you have an ileostomy or colostomy?

Question Title

* 6. Are you taking medication that needs to be injected or administered as an infusion?

Question Title

* 7. How long have you had IBD?

Question Title

* 8. What characteristics are important to you that your buddy has:

Question Title

* 9. What is your availability like?

Question Title

* 10. Please leave your name, number and email address below and we will contact you! 

T