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Peripheral Arterial Disease (PAD) Advancement Survey

We can't wait to hear from you!

You are invited to take part in a survey on Peripheral Arterial Disease (PAD), which will help inform resources we provide at the Amputee Coalition.

All responses are optional.

If you have any questions regarding this survey, please contact ddaniel@amputee-coalition.org.

Thank you!
1.Have you had an amputation (or are you at risk of having an amputation) due to PAD or other related diseases (i.e., diabetes, coronary artery disease, cerebrovascular disease)?
2.Would you like to tell us more about your response?
3.Did you receive a vascular screening/examination prior to having an amputation?
4.Would you like to tell us more about your response?
5.Did you see a vascular-based physician prior to amputation?
6.Would you like to tell us more about your response?
7.What age did you begin experiencing symptoms of PAD or other related diseases (i.e. diabetes, coronary artery disease, cerebrovascular disease)?

Please type your answer in a whole number of years (Example: 65)
8.How much time passed between your first experience of PAD-related symptoms and your PAD diagnosis from a physician?

Please type your answer in a whole number of days, weeks, months, or years (Example: 2 days, 2 weeks, 2 months, 2 years).
9.Did you feel fully informed (symptoms, awareness of condition/patient education, treatment options) when diagnosed with PAD or other related condition(s)?
10.Would you like to tell us more about your response?
11.Did you experience any barriers to access a vascular-based physician (such as insurance coverage restrictions, transportation, proximity to care, or other required accommodations)?
12.Would you like to tell us more about your response?
13.How much time passed between receiving your diagnosis of PAD (or related condition) and having your limb(s) amputated?

Please type your answer in a whole number of days, weeks, months, or years (Example: 2 days, 2 weeks, 2 months, 2 years).
14.Do you feel that all other conservative interventions or treatment options had been attempted before the decision was made to amputate your limb(s)?
15.Would you like to tell us more about your response?
16.Do you feel like you were presented with the most appropriate treatment options for your condition?
17.Would you like to tell us more about your response?
18.Did your physician or medical team provide you with instructions on how to obtain any/all resources that you may require after your amputation(s)?
19.Would you like to tell us more about your response?
20.If yes, were you able to access those needed resources?
21.Would you like to tell us more about your response?
22.Which resources (if any) do you feel were needed that you did not receive (i.e., mental health support, in-home care)?
23.What type of doctor performed your amputation procedure?
24.Did you receive follow-up care from a vascular-based physician?
25.Would you like to tell us more about your response?
26.Were you provided with information on how to obtain a prothesis and receive ongoing prothetic-related care?
27.Would you like to tell us more about your response?
28.What type of support/resources were you provided with after your amputation?
29.What else would you like us to know?
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