1. Voice your opinion to Medicare about medical devices and services!

Exit this survey

* 1. Please provide your first name, city and zip code, as well as a way to contact you if you'd like to share your story directly with policy makers. (We promise not to share identifying information without your express permission.)

* 2. Do you currently receive Medicare benefits, or not?

* 3. Do you receive BOTH Medicare and Medicaid benefits?

* 4. Are you under the age of 65?

5. Do you use medical devices or assistive technology in daily life?

* 6. Which of the following devices do you use most? (Choose no more than two devices.)

* 7. How long have you used medical devices or assistive technology?

* 8. Have you heard of the "CMS DME Competitive Bidding Program?"

* 9. In the past two years, have you encountered any of the problems listed below?

10. How did you hear about this survey?

11. Please tell your story about using medical devices and assistive technology.