Stuttering Self-Assessment Questionnaire
Welcome to CCRA's Questionnaire for People Who Stutter.
Do you have problems with any of the following:
- Fluency of speech
- Maintaining normal fluency and time patterning of speech
Do these problems interfere with your academic or occupational achievement or with your ability to communicate?
If so, read on...
We'd like you to answer some questions in regard to the study we are conducting to help us determine your eligibility. Please check any of the statements that apply to you. In the comment space, you may list additional symptoms or information that you'd like us to have.
Questions or Comments?
Please feel free to use the space below to list additional symptoms, ask questions or tell us more about yourself.
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Your Contact Information
We’d like to give you a call to discuss research studies. Please provide your best contact information below: