PRINT THIS QUESTIONNAIRE & MAIL, FAX OR EMAIL YOUR NUMBERED
ANSWERS |
1.) WHY DID THIS HAPPEN TO ME......DID I DO SOMETHING WRONG? |
2.) HOW MANY SYMPTOMS DOES YOUR CHILD HAVE & HOW SEVERE? |
3.) HOW LONG WAS YOUR CHILD IN THE HOSPITAL AFTER BIRTH? |
4.) DID YOUR CHILD HAVE ANY SURGERIES RELATED TO MOEBIUS SYNDROME
& WHAT WERE THE RESULTS? |
5.) HOW DOES A G-TUBE WORK......ARE THERE ANY PROBLEMS.....WILL MY
CHILD EVER EAT REGULAR FOOD AND SWALLOW? |
6.) DOES YOUR CHILD NEED SPEECH OR PHYSICAL THERAPY.....IF SO, WHAT
WERE THE RESULTS? |
7.) DOES YOUR CHILD EVER SMILE? |
8.) CAN YOU TELL ME SOMETHING ABOUT INSURANCE & FINANCIAL ASPECTS
OF MOEBIUS SYNDROME? |
9.) WHERE CAN I FIND OTHER PEOPLE TO TALK WITH ABOUT MOEBIUS
SYNDROME? |
10.) IN GENERAL,....DESCRIBE THE IMPACT OF MOEBIUS SYNDROME ON YOUR
FAMILY....WHAT ARE WE UP AGAINST? |