Name   

Age     Under 20 20 - 29 30 - 39 40 - 49 50+

Do you have MS? Yes No Would rather not say

Are you a member of the MS Society?  Yes No

Are you active within the MS Society?  Yes No

Have you joined because of the web site? Yes No

What town/county/country do you live in?

Which website feedback form are you completing? Young Person's MS North Herts MS

How often do you visit this web site? This is first time Once a week More than once a week Infrequently

What are your main interests in this site? Who are we? Weblog Social Events Links Other

If other, please state:

e-mail address:  

Please use the space below to either ask me or the North Herts MS Society any questions, feedback on the site and it's content, let me know whether you would like to see any other topics on this site or comment on the good and/or bad points (be kind!):

If you want me to get in contact with you, please leave your e-mail details.