C diff Detection Survey Question Title * 1. Which statement best characterizes you? Healthcare provider C diff survivor Currently infected with C diff Healthcare worker Caretaker of someone who had C diff Other (please specify) Question Title * 2. What is your age? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 3. Are you familiar with C diff? Extremely familiar Very familiar Somewhat familiar Not so familiar Not at all familiar Question Title * 4. If you’ve had C diff before, did your C Diff result in a hospital stay? Yes No Never had C diff Question Title * 5. If so, how long did your course of C diff last? Never had C diff Less than 2 weeks 2 - 4 weeks 4 - 6 weeks Greater than 6 weeks (please specify) Question Title * 6. While infected with C. diff, did any household members or visitors become infected? Yes No Never had C diff Question Title * 7. Did you receive patient education for at-home cleaning procedures? Yes No Never had C diff Question Title * 8. What products do you use to clean germs? Clorox Lysol Hand sanitizer Other (please specify) Question Title * 9. What are your germ-cleaning habits? Question Title * 10. Would you have found it helpful to have a product that allows you to see C diff spores on surfaces for better cleaning? (this product makes C. diff spores glow under UV light) Why or why not? Yes No Why or why not? Done