Background information

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* 1. Today's date:

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* 2. City/State:

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* 3. Age:

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* 4. Name of Hearing Care Professional:

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* 5. Gender:

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* 6. How would you describe the impact of social distancing (i.e., face masks, increased video calls, increased phone calls) on your ability to hear and communicate?

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* 7. What are the COVID-19 requirements in your state? (Check all that apply)

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* 8. What is your experience with hearing instruments?

Remote Care Experience

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* 9. What is your current experience with accessing healthcare remotely?
(Check ONE Box)

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* 10.  How would you compare this current remote hearing healthcare experience to previous remote healthcare experiences?

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* 11. How satisfied are you with ease of scheduling remote appointments with your Hearing Care Professional (HCP)?
(Check ONE box)

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* 12. What device are you using for your remote appointments with your HCP?
 (Check ONE box)

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* 13. How satisfied are you with the technical quality of the remote appointments with your HCP?

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* 14. How would you describe the ease of accessing the online screening?

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* 15.  How satisfied are you with packaging of the hearing instruments (and contents) that you received?
(Check ONE box)

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* 16.  How would you describe the ease of use of the Signia App?
 (Check ONE box)

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* 17. How satisfied are you with the quality of care received by your HCP remotely?
(Check ONE box)

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* 18. How likely are you to refer a friend to your HCP, to access hearing healthcare remotely?
(Check ONE box)

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* 19. How likely are you to access remote healthcare in the future, when social distancing guidelines are no longer required in your city/state?
(Check ONE box)

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* 20. How satisfied are you with your hearing aids overall, with respect to hearing and understanding across all listening situations?
(Check ONE box)

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