Traumatic brain injury (TBI) is common among those sustaining a traumatic spinal cord injury (tSCI) although rates vary associated with difficulties robustly identifying TBI. When a person with tSCI is admitted acutely, the usual TBI indicators can be invalidated by the interacting effects of the tSCI resulting in missed cases. Co-occurring TBI has been associated with increased length and cost of tSCI rehabilitation, smaller gains from admission to discharge and added difficulties with psychosocial functioning, adjustment and return to productivity. The real impacts are difficult to quantify because TBI is often missed and rates in New Zealand are unknown. Our objectives are to i) engage with and build relationships in proposed localities for a follow-on health delivery study and ii) develop a TBI diagnostic algorithm so that this can be used in this follow-on study to consistently capture TBI and understand impacts on outcomes for New Zealanders who sustain tSCI.