Survey for people who are blind or vision impaired
We're researchers at Stanford University interested in assistive technology. We're using this survey to learn more about how you get around. Anyone who completes the survey will be entered in a raffle for a $100 Amazon gift card.
Sign in to Google to save your progress. Learn more
What is your degree of visual difficulty? Choose one: *
What age group best describes you? Choose one:
Clear selection
Which gender best describes you? Choose one:
Clear selection
How often do you travel somewhere outside of your home? Choose one: *
The last few times you traveled outside of your home, did you travel with someone else? Choose one:
Clear selection
What are some things you find difficult about traveling outside of your home by yourself? Check all that apply: *
Required
Are there any other things you find difficult about traveling outside of your home by yourself? Please explain:
How do you travel longer distances? Choose all that apply: *
Required
Do you use any of these tools while walking? Choose all that apply: *
Required
Do you use anything else to help you get from one place to another? Examples include smartphone apps, GPS devices, or anything else. List everything that you use: *
Do you use, or are you familiar with any electronic travel aids? For example, electronic canes like Ultra Cane or We Walk cane, or smart wristbands like Sunu Band or Way Band. Choose one: *
Would you be interested in using an electronic travel aid like an electronic cane, smart wristband, or something else? Choose one: *
If you had the chance to buy an electronic travel aid that could help you avoid obstacles or navigate indoors or outdoors, how much would you consider spending on it? Choose one: *
If you have heard of electronic travel aids before, why don't you use one now? Select all that apply: *
Required
Which of these features are essential for an electronic travel aid to have in order to be useful to you? Check all that apply: *
Required
If an electronic travel aid had all the features you checked above, would you consider using it? Choose one: *
Would you consider using an electronic travel aid instead of your white cane, guide dog, or what you currently use to travel? Select one: *
Please enter your email address if would like to enter the raffle for a $100 Amazon gift card, or if you're interested in hearing from us:
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