Injection Usability Survey Form
Please provide your feedback on the usability and experience of the injection process or device. Your responses will help us improve usability and support.
How easy was it to use the injection device?
*
Very Difficult
1
2
3
4
Very Easy
5
1 is Very Difficult, 5 is Very Easy
How clear were the instructions for using the injection device?
*
Not Clear
1
2
3
4
Very Clear
5
1 is Not Clear, 5 is Very Clear
How comfortable did you feel during the injection process?
*
Very Uncomfortable
1
2
3
4
Very Comfortable
5
1 is Very Uncomfortable, 5 is Very Comfortable
How confident did you feel using the injection device?
*
Not Confident
1
2
3
4
Very Confident
5
1 is Not Confident, 5 is Very Confident
How effective was the training or demonstration you received?
*
Not Effective
1
2
3
4
Very Effective
5
1 is Not Effective, 5 is Very Effective
Which aspect of the injection process was most challenging?
*
Preparing the device
Understanding instructions
Administering the injection
Disposing of materials
None
Other
Please rate the following aspects of the injection process:
*
Rows
Very Poor
Poor
Average
Good
Excellent
Grip/handling
1
2
3
4
5
Button or trigger operation
6
7
8
9
10
Visual indicators
11
12
13
14
15
Instruction clarity
16
17
18
19
20
How likely are you to recommend this injection device or process to others?
*
Not Likely
1
2
3
4
Very Likely
5
1 is Not Likely, 5 is Very Likely
Was there anything that could be improved about the injection process or device?
*
Yes
No
Please share any additional comments or suggestions regarding the injection usability.
Submit Feedback
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