How did you hear about the British Tinnitus Association?

Would you be interested in attending a meeting for younger people?  Yes    No

Would you be happy to travel to attend a meeting?  Yes    No

Would you like to hear speakers?  Yes    No

Would you like to get involved in workshops?  Yes    No

Would you like to do a relaxation / stress management session?  Yes    No

Would you attend a day meeting?  Yes    No        

Would you attend a weekend meeting?  Yes     No

How much would you be willing to pay to attend a day meeting?

How much would you be willing to pay to attend a weekend meeting?

Would you like to take part in a sponsored event to raise funds for tinnitus?  Yes     No

How long have you had tinnitus for?

What do you think caused your tinnitus? 

Has anything you have tried eased your tinnitus? If so, can you tell us what?

Your date of birth

Are you Male    Female

Where do you live?  

If you would like to be contacted about future meetings, please leave your details below

Name, address and email: