II Week - Survey - Internet Friendships

1. Contact information:

Email Address Required Question

First Name Required Question

Last Name

Illness(es) Required Question

Title

Company Name

Street Address

City

State

Postal Code

Country

Phone Number

URL

2. On the average day, how many hours do you spend on the internet interacting with people who also have a chronic illness?

3. What year did you start looking for online support for your illness?

4. What ways do you most often interact with others?
(Sort in order of most commonly used and least commonly used by clicking the blue arrows for up and green arrows for down)

1]	email
2]	social networks
3]	blog
4]	instant messaging
5]	chat rooms
6]	forums
7]	other

5. How have your internet friendships made a difference in how you cope with illness on a daily basis?

6. What other ways have you connected with internet friends? (Check all that apply)

	phone
	posal mail
	in person visit
	other

7. Share any story about aspecial friendship and how it came to be.