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Medical equipment use research survey

What is your name?

What is your email?

What is your age?

*

A

Under 18

B

18-35

C

35-60

D

60+

E

Prefer not to answer

Which of these statements best describes you?

*

A

I use mobility, hearing, vision, or other medical aid equipment that is visible to others.

B

I don't use medical aid equipment that is visible to others.

C

I don't use medical aid equipment that is visible to others, but I need/needed one that I did not buy

What equipment do you use, or need/have needed but don't use?

*

Have you ever tried to decorate or change the appearance of your equipment?

A

Yes

B

No

C

Prefer not to answer

Have you ever tried to hide your equipment?

A

Yes

B

No

C

Prefer not to answer

If you have ever hidden, decorated, or changed the appearance of your equipment, when was the last time?

A

Today

B

This week

C

Within a month

D

Within a year

E

Within 5 years

F

5+ years ago

G

I don't remember

How do you feel about the aesthetics of your equipment?

12. Would you be willing to participate in a short follow-up interview?

*

A

Yes

B

No