Thank you for choosing to participate in this survey. The survey contains 5 sections with a total of 24 questions. The purpose is to gather outcome data, opinions, and testimonial accounts of therapists who are using AmTrykes with their clients. Thank you again for participating!

1. Are you an occupational therapist or a physical therapist?

Are you an occupational therapist or a physical therapist? OT

2. Please provide us with the city, state and zipcode in which you live:

Please provide us with the city, state and zipcode in which you live: City
State
Zip code

3. Are you associated with an AMBUCS Chapter?

Are you associated with an AMBUCS Chapter? Yes

If yes, which one?

Please review the following pictures to identify which models of the AmTryke® you use most frequently.

Ket-Trykes (Happy Navigator/ Jumbo/ Oceania)

AM - 9

Snappy

AM - 12

AM - 16

ProSeries - 1412

ProSeries - 1416

ProSeries - 1420

2700 - 20"

2700 - 24"

HP1000

1424

4. Please indicate how often you use the different models of the AmTryke® in practice from reviewing the previous pictures?

	Not at all	Occasionally	Frequently
Ket-Trykes (Happy Navigator/Jumbo/Oceania)	*Please indicate how often you use the different models of the AmTryke® in practice from reviewing the previous pictures? Ket-Trykes (Happy Navigator/Jumbo/Oceania) Not at all	Ket-Trykes (Happy Navigator/Jumbo/Oceania) Occasionally	Ket-Trykes (Happy Navigator/Jumbo/Oceania) Frequently
AM - 9	AM - 9 Not at all	AM - 9 Occasionally	AM - 9 Frequently
Snappy	Snappy Not at all	Snappy Occasionally	Snappy Frequently
AM - 12	AM - 12 Not at all	AM - 12 Occasionally	AM - 12 Frequently
AM - 16	AM - 16 Not at all	AM - 16 Occasionally	AM - 16 Frequently
Pro - 1412	Pro - 1412 Not at all	Pro - 1412 Occasionally	Pro - 1412 Frequently
Pro - 1416	Pro - 1416 Not at all	Pro - 1416 Occasionally	Pro - 1416 Frequently
Pro - 1420	Pro - 1420 Not at all	Pro - 1420 Occasionally	Pro - 1420 Frequently
2700 - 20"	2700 - 20" Not at all	2700 - 20" Occasionally	2700 - 20" Frequently
2700 - 24"	2700 - 24" Not at all	2700 - 24" Occasionally	2700 - 24" Frequently
HP1000	HP1000 Not at all	HP1000 Occasionally	HP1000 Frequently
1424	1424 Not at all	1424 Occasionally	1424 Frequently
Other	Other Not at all	Other Occasionally	Other Frequently

If Other, please specify the AmTryke® model

5. With which age groups do you use the AmTryke®? (Please check all that apply)

With which age groups do you use the AmTryke®? (Please check all that apply) 18 months - 4 years old

5 - 8 years old

9 - 12 years old

13 - 18 years old

19 years and older

If 19 or older, please specify age

6. Do you incorporate the AmTryke® into the client's home program if the client has access to an AmTryke® outside of therapy?

Do you incorporate the AmTryke® into the client's home program if the client has access to an AmTryke® outside of therapy? Not at all

Sometimes

Most of the time

Always

1. Section I - AmTryke Therapist Survey