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.1876-0321- Parkinson's 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) Are you able to join a 1 hour Zoom research session as a pair (one who provides care and one diagnosed with Parkinsons)? Check all that apply Yes No (This question is mandatory) Have you, or a family member or loved one, been diagnosed with Parkinson's by a healthcare professional? Choose one of the following answers Please choose... I have been diagnosed with Parkinson's A family member or loved one has been diagnosed with Parkinson's Neither apply (This question is mandatory) How are you related to the person who will join the research session with you? (This question is mandatory) Thinking about your living arrangements, please select which one applies to you: Choose one of the following answers Please choose... I have Parkinson's and live alone I have Parkinson's and live with family I have Parkinson's and live with friends I provide care and live with someone who has Parkinson's I provide care for someone with Parkinson's, but do not live with them N/A Other: Other: (This question is mandatory) How involved are you in the healthcare, treatment and management decision-making of your/their Parkinson's? Choose one of the following answers Please choose... No or minimal involvement Some involvement or shares in decisions High involvement (This question is mandatory) What year were you/your family member or loved one, diagnosed with Parkinson's by a healthcare professional? (This question is mandatory) Do you/ your family member or loved one, experience OFF- episodes or OFF-time? (When Parkinson's medication effect has worn off and is no longer providing benefit with regard to mobility, slowness and stiffness). Yes No (This question is mandatory) How much do OFF-episodes or OFF-time impact your/ their daily routines and activities? Choose one of the following answers Please choose... No impact Minimal impact Some impact Noticeable impact High impact Not applicable (This question is mandatory) Please specify what treatments you/ your family member or loved one, are currently receiving to manage Parkinson's? Submit Load unfinished survey Resume later Please confirm you want to clear your response? Exit and clear survey ×
