This questionnaire was originally compiled to gather statistics and it is revealing many interesting trends and information that is helpful to our Post  Polio Society. We plan to post some of these facts and figures on this site as we work through the questionnaires. Thank you to the many who have  responded and we have been overwhelmed with your willingness to share the details of your polio situation with us.

Another aspect that has resulted from distributing this questionnaire is that it is your own record of your polio history. Some people have duplicated the forms, and given them to their doctors and therapists to include in their files. In this way the medical professionals can have your unique polio history on hand when you visit them. Extra copies can be made as needed by downloading and printing them off.

You may also want to keep a copy for yourself and note any changes over the years. 

Download this questionnaire in PDF form here 

So keep an eye on this page for further up-dates on the questionnaire.  

The data from 390 surveys has now been processed, and the numbers will be added to as additional responses are received. 

Some information:

• 44% of respondents can now be contacted by email
• We have replies from 7 people who did not have polio (medical professionals, family members, carers) and we have 10 replies from non-members of the National body.  If you know any more people in these categories who need a questionnaire please let us know, so that our statistics can become truly representative.
• 93.84% of replies came from New Zealander Pakehas with the remaining 6.16% specifying their ethnic origins as 7 people who come from the UK , 5 who are Maori, 2 who are Europeans (country not specified,) 1 Chilean, 3 Australian, 1 Irish, 2 South African, 1 Yugoslav, 1 Indian, and 1 Canadian.
• Responses indicate 1 contracted polio in the Ukraine, 27 contracted polio in the UK, 6 in Australia, 1 in Chile, 1 in Papua New Guinea,1 in Ceylon, 2 in Canada, 2 in India, 1 in USA, 1 in Egypt,1 in Kenya, 1 contracted polio at sea en route to NZ, 4 in South Africa,1 in Germany, 1 in Ireland, 1 in Northern Ireland, with the remainder contracting polio in NZ.
• Age when polio was contracted

27 people got polio between birth and 1 year

216 people got polio between 1-10 years

88 people got polio between11-20 years

47 people got polio between 21-30 years

5 people got polio between 31-60 years

The youngest got polio at birth and the oldest respondent got polio at 53