JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Conversion Table of Inhalers for Laryngectomy patients - Feedback Form
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Section 1: User Information
Occupation/Role (e.g., Pharmacist, H&N Specialist Nurse, GP or ENT):
Pharmacist
H&N Specialist Nurse
GP
Otolaryngologist
Doctor
Other:
Clear selection
How comfortable you feel switching Prospective/Post-Total Laryngectomy patients from their dry powder inhaler to a suitable metered dose inhaler to be used with a spacer?
*
Very uncomfortable
Uncomfortable
Neutral
Comfortable
Very comfortable
How important do you think it is for healthcare providers to be conscious of the different types of inhalers suitable for Prospective/Post Laryngectomy patients?
*
Not important at all
Low importance
Neutral
Important
Very important
Section 2: User-Friendliness Assessment
On a scale of 1-5, how would you rate the user-friendliness of the conversion table of inhalers? (1 being very difficult, 5 being very easy)
*
Very difficult
1
2
3
4
5
Very easy
What specific aspects of the conversion table were user-friendly or difficult to use? Please provide details.
*
Your answer
Section 3: Impact Assessment
Did the conversion table of inhalers meet your expectations in terms of providing useful information?
*
Yes
No
Partially
How has the conversion table helped you in prescribing inhalers post-laryngectomy? Please share any specific examples or experiences: e.g. understanding, pre-ordering of medication, patient education, raising awareness
*
Your answer
Section 4: Suggestions for Improvement
Do you have any suggestions for improving the user-friendliness or effectiveness of the conversion table of inhalers?
*
Your answer
Are there any additional features or information you would like to see included in the conversion table?
*
Your answer
Section 5: Overall Feedback
How likely are you to recommend the conversion table of inhalers to others?
*
Very Unlikely
Unlikely
Neutral
Likely
Very Likely
Section 6: Additional Comments
Please provide any additional comments or suggestions regarding the conversion table of inhalers for laryngectomy patients.
*
Your answer
Thank you for taking the time to complete this feedback form. Your input is crucial in improving the usability and effectiveness of the conversion table for laryngectomy patients.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
