NKFI Patient Survey

The National Kidney Foundation of Indiana needs your input with the programs and services offered to those with, and at risk of developing kidney disease.  We hope that you will take a few moments to complete this brief survey so we can better understand how to best serve you.  

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What is your connection to kidney disease?
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If you are the family member or caretaker of someone with Chronic Kidney Disease, select the options that best describe them (Please check all that apply)
If you (or patient) have kidney disease, what stage are you (they)  in?
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What is your zip-code?
 What is your (or patient’s) race or ethnicity?
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Have you heard of the National Kidney Foundation of Indiana before?
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What programs and events presented by the National Kidney Foundation of Indiana have you (or patient) previously participated in? (Please check all that apply)
Which of the following services provided by the National Kidney Foundation of Indiana would you  (or patient)  most likely use? (Please check all that apply)
If you are the parent or caregiver of a patient with Chronic Kidney Disease, how can the NKFI better meet your needs?
How do you prefer to obtain information on kidney disease and transplantation? (Please check all that apply)
If online, in what format? (Please check all that apply)
Where else do you get your information? (Please check all that apply)
Additional comments on how the NKFI can better meet your needs
If you would like to learn more about the National Kidney Foundation of Indiana, please provide your name, email address, and phone number
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