Covid-19 Survey

SBH Scotland Coronavirus Survey

This is a survey to inform official statistics into the impact of the Coronavirus on the members of Spina Bifida Hydrocephalus Scotland. Thank you for your help in filling this in. If you need any help with it please do call our Helpline on 03455 211 300.

Question Title

* 1. Please give us your basic contact details

Name *

ZIP/Postal Code *

Email Address

Phone Number *

Question Title

* 2. Are you, or the person you care for, currently experiencing any of the symptoms associated with the Covid-19 infection?

Yes