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Dr. Brown's Medical Early Intervention Survey
*
1.
Contact Information
(Required.)
Name
Facility
State/Province
Country
2.
Please provide your email address if you would like to receive updates from Dr. Brown's Medical on webinars, products, and newsletters. Your information is safe with us and will never be provided to a third party.
*
3.
Discipline
(Required.)
PT
OT
SLP
Nurse
Other (please specify)
*
4.
What area(s) do you practice? Check all that apply.
(Required.)
Outpatient clinic
Home health
Hospital inpatient
Developmental f/u clinic
Telehealth
Rehab facility
Other (please specify)
*
5.
How many years of experience do you have?
(Required.)
0-5
6-10
11-15
More than 15
*
6.
With what percentage of your infant patient population do you address feeding issues?
(Required.)
0-25
26-50
51-75
76-100
*
7.
Please rank the following
webinar
topics on level of
importance
to you:
(Required.)
Not needed
Low Need
Moderate Need
High Need
Tongue tie/tethered oral tissue
Not needed
Low Need
Moderate Need
High Need
Breastfeeding
Not needed
Low Need
Moderate Need
High Need
Oral motor evaluation
Not needed
Low Need
Moderate Need
High Need
GI disorders
Not needed
Low Need
Moderate Need
High Need
Report/goal writing
Not needed
Low Need
Moderate Need
High Need
Cleft lip/palate
Not needed
Low Need
Moderate Need
High Need
Feeding skills after NICU discharge
Not needed
Low Need
Moderate Need
High Need
Therapeutic interventions
Not needed
Low Need
Moderate Need
High Need
Transitioning off of feeding tubes
Not needed
Low Need
Moderate Need
High Need
Feeding with specific syndromes
Not needed
Low Need
Moderate Need
High Need
Feeding infants with trachs/vents
Not needed
Low Need
Moderate Need
High Need
Please list any other topics or speakers you feel would be valuable
*
8.
Would you or your clinic be interested in purchasing products
in bulk
(e.g. a case of bottles or nipples)?
(Required.)
Yes
No
We already currently purchase in bulk
*
9.
How do you clean your therapy feeding tools? Check all that apply.
(Required.)
Steam sanitizer bags in microwave
Dishwasher
Hand wash
Autoclave
n/a; we do not reuse any products
Other (please specify)
*
10.
What are the top 3 feeding tools you use in therapy? Please choose up to 3 from the below list.
(Required.)
NUK brush
Chewy tube
Maroon Spoon
Syringe
Z vibe
Arc Probes
Ps and Qs
Straws
Flexi cup
Reflo cup
Other (please specify)
*
11.
What therapy tools do you recommend most to parents to purchase? Please select up to 3 from the list below.
(Required.)
Nuk brush
Chewy tube
Maroon spoon
Syringe
Z vibe
Arc Probes
Ps and Qs
Straws
Flexi cup
Reflo cup
Other (please specify)
12.
What other products would you like to see developed for feeding therapy?
*
13.
Describe the frequency you use the following
Dr. Brown's
products:
(Required.)
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
First Feeders
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Slow flow nipples - Ultra Preemie, Preemie, or Newborn
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Specialty Feeding System
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Wide neck bottle system
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Cleaning products
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Teethers
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Silicone Handles
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Mixing Pitcher
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Stage 1 pacifier
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Preemie Pacifier
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
PreVent pacifier
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Long Spatula spoon
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Silicone feeder
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
Make a smash food masher
Was not aware of this product
Never
Rarely
Sometimes
Often
Very frequently
*
14.
How frequently do you recommend parents purchase/use Dr. Brown's feeding products?
(Required.)
Never
1 star
Rarely
2 stars
Sometimes
3 stars
Often
4 stars
Very frequently
5 stars
Current Progress,
0 of 20 answered
