Please check the appropriate lines or fill in the blanks with your feelings and knowledge of cochlear implants.
2) I am between the ages of:
3) I consider myself:
4) To communicate, I use:
4b) My occupation:
5) Before completing this survey, I had 'heard of' CIs.
6) I feel that I have a good understanding of what a CI is/does.
7) To the best of my knowledge this is what a CI is/does . . .
(Do not hit return)
8) My feelings about CIs:
9) If I were offered a CI to help me hear, based on my current knowledge, I would consider getting an implant . . .
10 a) My contact with a person with a CI . . .
10 b) If yes, has the CI worked for that person?
(if you know/have met several recipients, please answer for each, or summarize)
10 c) If yes, explain your relationship to that person(those people).
11) I saw Jenn's project at the National CEC Conference April 2002.
NOTE: Thank you for filling in this survey. To receive a copy of the answers you gave in this survey type your email address in the comment box
and click SEND. Or you can print a copy of the answers you gave from the next page that opens. From that page you can use your Back button to return to the page you had before taking the survey.
SEND CLEAR
Survey Closed 2002
I conducted the following survey for an eclectic assortment of views. When the questions on the survey were completed, the answers were forwarded to me at jgoogoo79@yahoo.com
When finished, respondents indicated their consent for me to use the information for my research purposes as it applies to my university studies. Identifying information was removed and all answers used anonymously.
I want to express my thanks to all participants.
Jenn G
First, some demographic information to be used for classification of answers:
1) I am:
Male, Female
Under 13, 13-20, 21-28, 29-36, 37-44, 45-52, 53-60, 61-68, 69-77, 78-85,
86-93, 94-101
Deaf
deaf
hard of hearing
hearing
other (please specify) (Do not hit return)
Sign Language only (any type)
Speech only
A Mix of both sign and speech
other (please specify)
Yes
No
Yes
No
(If you have no idea, please write N/A; if you have ideas, please jot them down in your own words).
1=Strong Against, 2=A Little Against, 3=Mixed Feelings, 4=A Little FOR, 5=Strong FOR
Strong Against
A little Against
Mixed
A little For
Strong For
Yes
No
I Know someone
Yes I have met someone
NO I do not know anyone
If NO go to Q 11
Yes
No
Not yet certain
For example: friend, teacher, sister, mother, acquaintance
Yes
No
CONSENT: By clicking "SEND" I indicate I give consent to use of my answers by Jenn Geguzis and Bloomsburg University of Pennsylvania. I agree that any identifying information (for example the email address for a copy of the survey answers) will be removed and not shared in presentations Jenn Geguzis makes about CIs.