Toggle navigation Load unfinished survey Resume later Exit and clear survey default Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters. H.1929-0521- Duchenne Muscular Dystrophy You are about to fill in a short survey which will help determine your suitability to this research project. Please be aware that all data you provide us with will be held in accordance with the data protection policy outlined on our website. For further information please visit https://www.healthcareopinions.co.uk/privacy-policy/ (This question is mandatory) What is your name, contact number and email address? First Name Surname Contact Number Email Address Postcode (This question is mandatory) Please tell us your age. Only numbers may be entered in this field. Your answer must be between 1 and 99 (This question is mandatory) Are you... Choose one of the following answers Male Female Prefer not to say Other: (This question is mandatory) What is your working status? Choose one of the following answers Please choose... Full time Part Time Non working Retired Housewife/househusband In education Other: Other: (This question is mandatory) If applicable, what is your occupation? (This question is mandatory) Are your details currently registered with us? If you haven't, please do so here http://https://www.healthcareopinions.co.uk/ Choose one of the following answers Yes No (This question is mandatory) Where did you hear about this research participation opportunity? Check all that apply Email directly from Research Opinions Recommended from a friend or family member Healthcare Opinions website Facebook Instagram Other: (This question is mandatory) Which of these applies to you? Choose one of the following answers Please choose... I have been diagnosed with Duchenne Muscular Dystrophy (DMD) I provide care to a family member who has been diagnosed with Duchenne Muscular Dystrophy ( DMD) Neither of these If you are providing care for a family member who has been diagnosed with DMD, what is your relationship to them? (This question is mandatory) What is the age of the family member you are providing care for? (This question is mandatory) If you are providing care for a family member, which of these activities do you assist with? Check all that apply Remembering to take medication Making decisions about treatment , along with the individual and physician Attending doctors appointments Daily activities None of these (This question is mandatory) At what age were you/ the person you provide care for diagnosed with DMD? What treatments do you/ the person you provide care for currently take for DMD? (This question is mandatory) What type of doctor treats you/ the person you provide care for for DMD? Check all that apply Paediatric Neurologist Adult Neurologist Paediatric Pulmonologist Adult Pulmonologist Paediatric Cardiologist Adult Cardiologist Other: (This question is mandatory) If applicable, at what age did you/ the person you provide care for transfer from a paediatric to an adult specialist? (This question is mandatory) If applicable, on a scale of 1-10 , with 1 not being comfortable at all and 10 being extremely comfortable, how comfortable were you with the transition of care from paediatric to adult care? Choose one of the following answers Please choose... 1 2 3 4 5 6 7 8 9 10 Not applicable (This question is mandatory) On a scale of 1-10, with 1 being not comfortable at all, and 10 being extremely comfortable, how comfortable are you with using a computer and internet, such as sending emails and navigating the web? Choose one of the following answers Please choose... 1 2 3 4 5 6 7 8 9 10 Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×
