Consumer Reports Survey/Study on Hip and Knee Replacement

consumerreports We're looking for #hip & #knee surgery patients/caregivers for a study. Help us improve #healthcare !!! http://t.co/JU6kWPCa6f 1/14/14 11:22 AM

 (Twitter notice.)

 Go to this link to complete and submit your information and selected participants receive a complimentary ConsumerReports.org subscription!*

https://docs.google.com/forms/d/1hepaOMPFpiDexw7tSQfCWVtpxteWzaBT_5-DR91LOgs/viewform

(Example Only)  User Questionnaire

Hello,

Thanks for your interest in our Hip & Knee Surgery study. This short questionnaire verifies your eligibility for an upcoming customer interview. The interview will help us better understand your needs in order to incorporate them into a new product we're developing.

Interviews will be held over a Google Hangout or telephone. If you’re interested in participating, please complete the questionnaire below. If you're selected, we’ll be in touch directly to discuss details and set your appointment time.

Details of the study:

- The duration of the interview is 30 minutes

- Participants will receive a complimentary ConsumerReports.org subscription*

To participate you will need to:

- Be at least 18 years old

- Allow us to video or audio record the session

* Please note that you will receive the complimentary subscription only if you are selected as a participant and attend the interview.

Thank you for your time.

Sincerely,

Patricia Ju, Shane Shelley, and Chris Baily

Technology Innovation Center

Consumer Reports

 * Required

1.             Availability *
Mark ALL time slots for which we could schedule an appointment with you.

         Weekdays Morning

         Weekdays Afternoon

         Weekdays Evening

         Saturdays Morning

         Saturdays Afternoon

         Saturdays Evening

         Other:

2.             


First and last name: *




Best email address to reach you: *




Best phone number to reach you: *




What state do you currently reside in? 




Gender: *


         Male

         Female

         Prefer not to say

3.             


Age: *


         Under 18

         18-21

         22-28

         29-34

         35-44

         45-65

         66-75

         76 Plus

         Prefer not to say

4.             


What experience do you have with Hip or Knee Surgery? *
Caregiver is an individual, such as a parent or child, who attends to the needs of a child or dependent adult

         Currently considering Hip or Knee Surgery

         Currently a caregiver for a candidate for Hip or Knee Surgery 

         Recently had Hip or Knee Surgery

         Curious about information on Hip or Knee Surgery