Join our Stroke Recovery Program

Have you or a loved one had a stroke?

We’re looking for people who have experienced a stroke or are caregivers for stroke survivors to participate in a community-driven initiative to enhance stroke recovery.

The program will include integrating physical exercise, social interaction, and creative thinking activities (e.g., movement to music, art or singing) to enhance stroke survivors’ overall well-being and quality of life.

We need your help to understand how to improve recovery and life after a stroke.

If you want to be involved or learn more, you can sign up below.

Stroke Recovery Program

Join a list of people who have experienced a stroke who will be contacted when researchers need people to participate in the program or learn more about it. Please complete the form below. If you have any questions, contact our team on (02) 4042 0417 or by emailing Heidi.Janssen@health.nsw.gov.au.

Consent to join the register
Understanding & consent*
- Select All
- I would like more information on the program please
- I understand that I can withdraw at any time without providing a reason.
- I understand that my personal information will remain confidential to members of the Registry project team.
Contact details
Who are you completing this form for?*
Your name*
Prefix First Last
Please list the patient's name.
Your name (if compleing the form for someone else)
Prefix First Last
Gender*
Please list the patient's gender.
Date of birth*
Please list the patient's DOB
Best contact email*
Enter Email Confirm Email
Phone number*
Alternative phone number*
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Your stroke experience
Have you had a stroke?*
Was your last stroke within the last five years?
Anything else we should know?
You're a real person?
Time to submit!*
I am ready to submit my information
Comments
This field is for validation purposes and should be left unchanged.