Boundless Bracing Orthotic Quality Assurance Tool

This survey aims to collect data about the perceived quality of the orthotic devices. By entering data you agree to allow the data to be used for the research or teaching. No identifying information will be made public in either research or teaching.

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* 1. User name (optional)

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* 2. What is your profession?

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* 3. How long have you worked in Orthotics (in years)?

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* 4. Are you a graduate of an accredited education program?

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* 5. What type of setting do you work in?

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* 6. What province do you work in

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* 7. Please rank the following with respect to the plastic shell;

	1 Poor	2 Fair	3 Acceptable	4 Good	5 Excellent	N/A
Is the plastic type correct?	Is the plastic type correct? 1 Poor	Is the plastic type correct? 2 Fair	Is the plastic type correct? 3 Acceptable	Is the plastic type correct? 4 Good	Is the plastic type correct? 5 Excellent	Is the plastic type correct? N/A
Is the plastic thickness correct?	Is the plastic thickness correct? 1 Poor	Is the plastic thickness correct? 2 Fair	Is the plastic thickness correct? 3 Acceptable	Is the plastic thickness correct? 4 Good	Is the plastic thickness correct? 5 Excellent	Is the plastic thickness correct? N/A
Does the plastic architecture meet design specifications?	Does the plastic architecture meet design specifications? 1 Poor	Does the plastic architecture meet design specifications? 2 Fair	Does the plastic architecture meet design specifications? 3 Acceptable	Does the plastic architecture meet design specifications? 4 Good	Does the plastic architecture meet design specifications? 5 Excellent	Does the plastic architecture meet design specifications? N/A
Rate the quality of the plastics surface.	Rate the quality of the plastics surface. 1 Poor	Rate the quality of the plastics surface. 2 Fair	Rate the quality of the plastics surface. 3 Acceptable	Rate the quality of the plastics surface. 4 Good	Rate the quality of the plastics surface. 5 Excellent	Rate the quality of the plastics surface. N/A
Does the device show signs of deformation (eg. shrinkage or expansion)	Does the device show signs of deformation (eg. shrinkage or expansion) 1 Poor	Does the device show signs of deformation (eg. shrinkage or expansion) 2 Fair	Does the device show signs of deformation (eg. shrinkage or expansion) 3 Acceptable	Does the device show signs of deformation (eg. shrinkage or expansion) 4 Good	Does the device show signs of deformation (eg. shrinkage or expansion) 5 Excellent	Does the device show signs of deformation (eg. shrinkage or expansion) N/A
Do the trimlines meet the criteria provided?	Do the trimlines meet the criteria provided? 1 Poor	Do the trimlines meet the criteria provided? 2 Fair	Do the trimlines meet the criteria provided? 3 Acceptable	Do the trimlines meet the criteria provided? 4 Good	Do the trimlines meet the criteria provided? 5 Excellent	Do the trimlines meet the criteria provided? N/A

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* 8. Additional comments about plastic (optional).

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* 9. If there is NO Componetry (ie. joints or metal uprights) in the device please proceed to question 12.
If the device does include Componentry please rank the following;

	1 Poor	2 Fair	3 Acceptable	4 Good	5 Excellent	N/A
Does the componentry meet design specifications?	Does the componentry meet design specifications? 1 Poor	Does the componentry meet design specifications? 2 Fair	Does the componentry meet design specifications? 3 Acceptable	Does the componentry meet design specifications? 4 Good	Does the componentry meet design specifications? 5 Excellent	Does the componentry meet design specifications? N/A
Is the placement/location of componentry correct?	Is the placement/location of componentry correct? 1 Poor	Is the placement/location of componentry correct? 2 Fair	Is the placement/location of componentry correct? 3 Acceptable	Is the placement/location of componentry correct? 4 Good	Is the placement/location of componentry correct? 5 Excellent	Is the placement/location of componentry correct? N/A
Is the installation of componentry correct?	Is the installation of componentry correct? 1 Poor	Is the installation of componentry correct? 2 Fair	Is the installation of componentry correct? 3 Acceptable	Is the installation of componentry correct? 4 Good	Is the installation of componentry correct? 5 Excellent	Is the installation of componentry correct? N/A
Is the alignment of componentry correct?	Is the alignment of componentry correct? 1 Poor	Is the alignment of componentry correct? 2 Fair	Is the alignment of componentry correct? 3 Acceptable	Is the alignment of componentry correct? 4 Good	Is the alignment of componentry correct? 5 Excellent	Is the alignment of componentry correct? N/A
Is the metal work appropriate (eg. material selection, contouring and/or finishing)?	Is the metal work appropriate (eg. material selection, contouring and/or finishing)? 1 Poor	Is the metal work appropriate (eg. material selection, contouring and/or finishing)? 2 Fair	Is the metal work appropriate (eg. material selection, contouring and/or finishing)? 3 Acceptable	Is the metal work appropriate (eg. material selection, contouring and/or finishing)? 4 Good	Is the metal work appropriate (eg. material selection, contouring and/or finishing)? 5 Excellent	Is the metal work appropriate (eg. material selection, contouring and/or finishing)? N/A

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* 10. Comments about Componentry (optional).

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* 11. Rank the following with respect to the Strap/s;

	1 Poor	2 Fair	3 Acceptable	4 Good	5 Excellent	N/A
Does the strap/s meet design specifications	Does the strap/s meet design specifications 1 Poor	Does the strap/s meet design specifications 2 Fair	Does the strap/s meet design specifications 3 Acceptable	Does the strap/s meet design specifications 4 Good	Does the strap/s meet design specifications 5 Excellent	Does the strap/s meet design specifications N/A
Is the position of strap/s correct	Is the position of strap/s correct 1 Poor	Is the position of strap/s correct 2 Fair	Is the position of strap/s correct 3 Acceptable	Is the position of strap/s correct 4 Good	Is the position of strap/s correct 5 Excellent	Is the position of strap/s correct N/A
Is the length of strap/s correct?	Is the length of strap/s correct? 1 Poor	Is the length of strap/s correct? 2 Fair	Is the length of strap/s correct? 3 Acceptable	Is the length of strap/s correct? 4 Good	Is the length of strap/s correct? 5 Excellent	Is the length of strap/s correct? N/A
Is the orientation/direction of strap/s correct?	Is the orientation/direction of strap/s correct? 1 Poor	Is the orientation/direction of strap/s correct? 2 Fair	Is the orientation/direction of strap/s correct? 3 Acceptable	Is the orientation/direction of strap/s correct? 4 Good	Is the orientation/direction of strap/s correct? 5 Excellent	Is the orientation/direction of strap/s correct? N/A
Are the strap/s attached correctly?	Are the strap/s attached correctly? 1 Poor	Are the strap/s attached correctly? 2 Fair	Are the strap/s attached correctly? 3 Acceptable	Are the strap/s attached correctly? 4 Good	Are the strap/s attached correctly? 5 Excellent	Are the strap/s attached correctly? N/A

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* 12. Comments about Strap/s (optional).

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* 13. With respect to the design specification of any Additions (eg. padding, wedges, fillers etc.) please rank the following;

	1 Poor	2 Fair	3 Acceptable	4 Good	5 Excellent	N/A
Is the placement/ location correct?	Is the placement/ location correct? 1 Poor	Is the placement/ location correct? 2 Fair	Is the placement/ location correct? 3 Acceptable	Is the placement/ location correct? 4 Good	Is the placement/ location correct? 5 Excellent	Is the placement/ location correct? N/A
Is the installation correct?	Is the installation correct? 1 Poor	Is the installation correct? 2 Fair	Is the installation correct? 3 Acceptable	Is the installation correct? 4 Good	Is the installation correct? 5 Excellent	Is the installation correct? N/A
Do additions meet measurements provided?	Do additions meet measurements provided? 1 Poor	Do additions meet measurements provided? 2 Fair	Do additions meet measurements provided? 3 Acceptable	Do additions meet measurements provided? 4 Good	Do additions meet measurements provided? 5 Excellent	Do additions meet measurements provided? N/A
Are fasteners/adhesion appropriate?	Are fasteners/adhesion appropriate? 1 Poor	Are fasteners/adhesion appropriate? 2 Fair	Are fasteners/adhesion appropriate? 3 Acceptable	Are fasteners/adhesion appropriate? 4 Good	Are fasteners/adhesion appropriate? 5 Excellent	Are fasteners/adhesion appropriate? N/A
Is the quality of the transition between materials appropriate?	Is the quality of the transition between materials appropriate? 1 Poor	Is the quality of the transition between materials appropriate? 2 Fair	Is the quality of the transition between materials appropriate? 3 Acceptable	Is the quality of the transition between materials appropriate? 4 Good	Is the quality of the transition between materials appropriate? 5 Excellent	Is the quality of the transition between materials appropriate? N/A

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* 14. Comments about Additions (optional).

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* 15. Rank the following with respect to the finishing quality of the device;

	1 Poor	2 Fair	3 Acceptable	4 Good	5 Excellent	N/A
Edges and trimlines ...etc	Edges and trimlines ...etc 1 Poor	Edges and trimlines ...etc 2 Fair	Edges and trimlines ...etc 3 Acceptable	Edges and trimlines ...etc 4 Good	Edges and trimlines ...etc 5 Excellent	Edges and trimlines ...etc N/A
Cosmesis	Cosmesis 1 Poor	Cosmesis 2 Fair	Cosmesis 3 Acceptable	Cosmesis 4 Good	Cosmesis 5 Excellent	Cosmesis N/A
Cleanliness	Cleanliness 1 Poor	Cleanliness 2 Fair	Cleanliness 3 Acceptable	Cleanliness 4 Good	Cleanliness 5 Excellent	Cleanliness N/A
Transfer quality	Transfer quality 1 Poor	Transfer quality 2 Fair	Transfer quality 3 Acceptable	Transfer quality 4 Good	Transfer quality 5 Excellent	Transfer quality N/A
Rivets	Rivets 1 Poor	Rivets 2 Fair	Rivets 3 Acceptable	Rivets 4 Good	Rivets 5 Excellent	Rivets N/A
Sewing	Sewing 1 Poor	Sewing 2 Fair	Sewing 3 Acceptable	Sewing 4 Good	Sewing 5 Excellent	Sewing N/A
Is the overall alignment correct?	Is the overall alignment correct? 1 Poor	Is the overall alignment correct? 2 Fair	Is the overall alignment correct? 3 Acceptable	Is the overall alignment correct? 4 Good	Is the overall alignment correct? 5 Excellent	Is the overall alignment correct? N/A

Boundless Bracing Orthotic Quality Assurance Tool

Question Title

* 1. User name (optional)

Question Title

* 2. What is your profession?

Question Title

* 3. How long have you worked in Orthotics (in years)?

Question Title

* 4. Are you a graduate of an accredited education program?

Question Title

* 5. What type of setting do you work in?

Question Title

* 6. What province do you work in

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* 7. Please rank the following with respect to the plastic shell;

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* 8. Additional comments about plastic (optional).

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* 9. If there is NO Componetry (ie. joints or metal uprights) in the device please proceed to question 12.
If the device does include Componentry please rank the following;

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* 10. Comments about Componentry (optional).

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* 11. Rank the following with respect to the Strap/s;

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* 12. Comments about Strap/s (optional).

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* 13. With respect to the design specification of any Additions (eg. padding, wedges, fillers etc.) please rank the following;

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* 14. Comments about Additions (optional).

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* 15. Rank the following with respect to the finishing quality of the device;

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* 16. Additional comments about finishing quality (optional).

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* 17. Is this device appropriate to be dispensed?

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* 1. User name (optional)

Question Title

* 2. What is your profession?

Question Title

* 3. How long have you worked in Orthotics (in years)?

Question Title

* 4. Are you a graduate of an accredited education program?

Question Title

* 5. What type of setting do you work in?

Question Title

* 6. What province do you work in

Question Title

* 7. Please rank the following with respect to the plastic shell;

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* 8. Additional comments about plastic (optional).

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* 9. If there is NO Componetry (ie. joints or metal uprights) in the device please proceed to question 12. If the device does include Componentry please rank the following;

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* 10. Comments about Componentry (optional).

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* 11. Rank the following with respect to the Strap/s;

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* 12. Comments about Strap/s (optional).

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* 13. With respect to the design specification of any Additions (eg. padding, wedges, fillers etc.) please rank the following;

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* 14. Comments about Additions (optional).

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* 15. Rank the following with respect to the finishing quality of the device;

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* 16. Additional comments about finishing quality (optional).

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* 17. Is this device appropriate to be dispensed?

* 9. If there is NO Componetry (ie. joints or metal uprights) in the device please proceed to question 12.
If the device does include Componentry please rank the following;