Which Cushion is Suitable for You?

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

How important is skin protection to you? *

Not Important - No history of skin breakdown, doesn't sit full-time, able to perform independent weight shift, no concerns with skin integrity

Slightly Important - Seated part-time to full-time, have full sensation, able to perform independent weight shift, no history of pressure injury

Somewhat Important - Seated full time, have partial sensation, able to perform independent weight shift, no history of pressure injury

Important - Seated full-time, may have partial or no sensation, may/may not be able to perform independent weight shifts, have a history of pressure injury

Very Important - Seated full-time, have no sensation, have difficulty performing independent weight shifts, have a current pressure injury or history of pressure injuries, may have other complicating health factors

How often do you need positioning to accommodate and/or correct your individual posture? *

Never - Able to maintain your ideal seated position without leaning to the side or forward/backward

Rarely - Able to maintain your ideal seated position but could benefit from some cushion adjustment

Occasionally - Able to obtain your ideal seated position but needs assistance to maintain position over long periods of time

Frequently - Able to obtain your ideal seated position but requires positioning to maintain that posture

Always - Not able to obtain your ideal seated position without assistance.

How important is cushion stability is to you? *

Not Important - I have no difficulty maintaining my optimal posture all day on any surface

Slightly Important - I have some difficulty by the end of the day to maintain my optimal posture

Somewhat Important - I have difficulty maintaining a functional upright posture for more than a few hours without support

Important - I have difficulty maintaining a functional posture within a few hours without support

Very Important - I cannot maintain a functional posture without support

Name *

Email *

Phone Number *

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