This free survey is powered by
0%
Exit Survey
 
 
What is your age?
 
18 - 29
 
30 - 39
 
40 - 49
 
50 - above
 
 
 
What is you gender?
 
Male
 
Female
 
 
 
Which of following categories best describe your employment status?
 
Employed
 
Not employed, looking for work.
 
Not employed, NOT looking for work
 
Retired
 
Disabled, not able to work
 
 
 
In which type of housing do you currently living?
 
Apartment
 
Single-family home
 
Multi-family home
 
Two story house
 
Institution or hospital
 
Nursing home or assisted living facilities
 
Other
 
 
 
 
Who live with you (Select all that apply)?
 
Nobody
 
Spouse/partner
 
Family
 
Friend
 
Other residents
 
Other
 

 
 
 
Describe the entrance to your home (Select all that apply)?
 
Level entrance
 
Ramp
 
Lift
 
Elevator
 
No wheelchair accessible
 
Other
 

 
 
 
In which area of your house you find most difficult to use (Select all that apply)?
 
Front entrance
 
Hall
 
Bedroom
 
Kitchen
 
Dining room
 
Toilet
 
Staircase
 
Garage
 
Hallway
 
Other
 

 
 
 
What kind of difficulties you find while in home (Select all that apply)?
 
Accessibility
 
Doing daily routine
 
Security and safety
 
Health care
 
Entertainment
 
Other
 

 
 
 
What kind of improvement you want to have in your house (Select all that apply)?
 
Home Automation System
 
Security System
 
Entertainment System
 
Heating, Ventilation and Air Conditioning System (HVAC)
 
Health Care
 
Other
 

 
 
Please indicate your response to the following statements
Strongly Agree Agree Neutral Disagree Strongly Disagree
Design/System/Technology in current home suitable for disabled people
Need help/assistance to do daily routine/house chores
Ready to be independent and living on your own
I know about Smart home
I want to know more about Smart home for disabled people
Technology do help improving living quality of disabled people
 
Share This Survey:          Survey Software Powered by QuestionPro Survey Software