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

* 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.