Wheelchair Repair Survey

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This survey is looking for information on the experience that wheelchair users have getting their equipment serviced and repaired.

I am a resident of: *

If “Other” resident of:

I am a: *

Manual wheelchair user

Power wheelchair user

User of another assistive device (explain below)

Other:

My (primary) wheelchair is a: *

Group 1 device (Transport Wheelchair)

Group 2 device (Standard Weight Wheelchair)

Group 3 device (Lightweight Wheelchair)

Group 4 device (Ultra-lightweight Wheelchair)

Group 5 device (Recliner Wheelchair)

Group 6 device (Heavy Duty Wheelchair)

Other:

For health insurance, I use: *

Private insurance only

Public insurance (e.g. Medicare/Medicaid) only

A mixture of private insurance and public insurance

I do not carry health insurance.

Other:

The company who services my wheelchair is: (company name)

I would characterize my service provider as: *

A locally owned “mom and pop” wheelchair and medical equipment shop with 3 or fewer locations

Part of a regional chain of wheelchair and medical equipment shops

Part of a large, national provider of wheelchairs and medical equipment (e.g. NuMotion, National Seating, etc.)

I chose this service and repair supplier because: *

The hospital I received care from for my injury directed me to them.

My insurer mandated that I use them

I researched local wheelchair suppliers and chose them based on price, reputation, location, etc.

They were recommended to me by a friend, physician, acquaintance, etc.

They are the only provider in my area

Other:

I have required service or repair for my chair in the past year: *

Not at all

Once

2-3 times

4 times or more

Considering all your requests for service or repair with your current provider, the average time that expired between your initial request for service and when the repair was completed was: *

Less than a week

1 to 3 weeks

4 to 6 weeks

7 to 10 weeks

11 to 16 weeks

16 to 24 weeks

More than 24 weeks

Other:

Considering the problems or issues that prompted you to make a service request, what percentage of those do you feel could be performed by a friend, family member or independent repair professional with the right information, access to parts, etc.? *

Not many (fewer than 10%)

Some (around 25%)

Many (up to 50%)

Most (more than 50%)

All (100%)

Other:

The biggest challenge(s) I have encountered getting my wheelchair serviced and repaired are: (pick no more than three) *

Long wait for service and parts

Poor quality repair/service

Lack of choice in service/repair providers

Repair technician doesn’t understand my unique needs

Cost of service/repair

Other:

Required

A pending law in Colorado would create a legal right to repair wheelchairs and provide wheelchair owners and independent repair shops with access to schematics, diagnostic tools, parts and other information needed to make repairs. I feel this law, if passed, would: *

Make life better for wheelchair owners by making it easier to get wheelchairs serviced and repaired

Make life worse for wheelchair owners by allowing chair owners and independent shops to work on wheelchairs without prior “authorization” by wheelchair manufacturers

Make no difference to wheelchair owners - things will stay the same regardless.

Other:

Rate your response to the following statement: “As a wheelchair user, I would benefit from more choices for having my wheelchair serviced and repaired, including the option to repair it myself.” *

Strongly disagree

Strongly agree

Feel free to add any additional comments regarding your experiences with repair and service as a wheelchair user :

I am willing to be contacted by the survey organizers regarding my responses to this survey: *

Yes

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