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2014
December
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Neck collar-Questionnaire
Neck collar-Questionnaire
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Exit Survey
Hello! You are invited to participate in this research protocol. In this task, you will be asked to complete a survey that asks questions about daily habits, wellness, previous neck injuries. It will take approximately five minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may ask the main investigator Elisabetta Ferrari (
[email protected]
).
Thank you very much for your time and support.
I Agree
Do you spend a lot of time seated during the day?
Yes
No
If Yes, how many hours a day approximately?
2
4
More than 4
8
More than 10
Other
Do you spend time in front of an Information Technology (IT) device during your day (e.g. laptop, PC, tablet, smartphone,...)?
Yes
No
If Yes, how many hours a day approximately?
Less than two
More than four
More than seven
Ten
Other
What kind of IT device do you spend the larger amount of time on?
Laptop
Desktop computer
E-book reader
Mobile Phone
Tablet
Smartphone
Other
Have you experienced neck pain in the last three months?
Yes
No
If Yes, how long did you experience it?
One day
More than three days
A week
A month
Regularly during a specific period of the day
Other
Did you experience neck pain during specific periods of the day?
In the morning
After a period of time in front of a PC
After physical activity
In the evening
Other
Did you experienced major neck injuries (whiplash, surgery,..)?
Yes
No
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