Lymphedema Device Feedback Survey
Please share your experience and feedback regarding your use of the lymphedema device. Your responses will help us improve our products and services.
Your Name
First Name
Last Name
Your Email Address
example@example.com
How long have you been using the lymphedema device?
*
Please Select
Less than 1 month
1-3 months
4-6 months
More than 6 months
How often do you use the device?
*
Please Select
Daily
A few times a week
Once a week
Less than once a week
Please rate your overall satisfaction with the lymphedema device.
*
1
2
3
4
5
Please indicate your level of agreement with the following statements about the lymphedema device.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The device is easy to use.
1
2
3
4
5
The device is comfortable during use.
6
7
8
9
10
I have noticed improvement in my symptoms.
11
12
13
14
15
The instructions provided are clear.
16
17
18
19
20
The device is easy to clean and maintain.
21
22
23
24
25
Have you experienced any side effects or issues while using the device?
*
No
Yes (please specify below)
If you answered yes to the previous question, please describe the side effects or issues you experienced.
How does this device compare to any previous treatments or devices you have used for lymphedema?
*
Much better
Somewhat better
About the same
Somewhat worse
Much worse
Not applicable / First device used
How likely are you to recommend this device to others with lymphedema?
*
Not at all likely
1
2
3
4
5
6
7
8
9
Extremely likely
10
1 is Not at all likely, 10 is Extremely likely
What suggestions do you have for improving the lymphedema device?
Submit Feedback
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