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Your Remote Care Experience with your Hearing Care Professional

Background information

1.Today's date:(Required.)
2.City/State:(Required.)
3.Age:(Required.)
4.Name of Hearing Care Professional:(Required.)
5.Gender:(Required.)
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?(Required.)
7.What are the COVID-19 requirements in your state? (Check all that apply)(Required.)
8.What is your experience with hearing instruments?(Required.)
Remote Care Experience
9.What is your current experience with accessing healthcare remotely?
(Check ONE Box)(Required.)
10. How would you compare this current remote hearing healthcare experience to previous remote healthcare experiences?(Required.)
11.How satisfied are you with ease of scheduling remote appointments with your Hearing Care Professional (HCP)?
(Check ONE box)
(Required.)
12.What device are you using for your remote appointments with your HCP?
 (Check ONE box)(Required.)
13.How satisfied are you with the technical quality of the remote appointments with your HCP?(Required.)
14.How would you describe the ease of accessing the online screening?(Required.)
15. How satisfied are you with packaging of the hearing instruments (and contents) that you received?
(Check ONE box)(Required.)
16. How would you describe the ease of use of the Signia App?
 (Check ONE box)(Required.)
17.How satisfied are you with the quality of care received by your HCP remotely?
(Check ONE box)(Required.)
18.How likely are you to refer a friend to your HCP, to access hearing healthcare remotely?
(Check ONE box)(Required.)
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)(Required.)
20.How satisfied are you with your hearing aids overall, with respect to hearing and understanding across all listening situations?
(Check ONE box)(Required.)