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Participant survey

Thank you for participating

This survey will take you about 2 minutes to complete. Your answers will help us determine if you meet the criteria for our research. Your responses will be kept confidential. We will contact you within 5 business days of receiving your response if you have been selected to participate in our study. 
1.Are you male or female?(Required.)
2.How old are you?(Required.)
3.In the past 12 months, did you have back, hip, shoulder, or knee surgery?(Required.)
4.Did you live in one of the following states at the time of your surgery?(Required.)
5.How would you describe the population of your community?(Required.)
6.What was the approximate month and year of your surgery?(Required.)
7.Did you have coverage through a Medicare Advantage plan at the time of your surgery?(Required.)
8.If requested, could you provide the name of the doctor and the location (hospital or facility) where the surgery took place?(Required.)
9.How comfortable are you with sharing your opinions and experiences?(Required.)
10.What is your preferred language?(Required.)
11.If you are comfortable using email, please enter your email address.
12.What is your phone number?(Required.)
13.What is your name?(Required.)
Current Progress,
0 of 13 answered