Demographics of person with DCM

To ensure we have heard opinions representing the many ways DCM can affect people, it is important for us to gain insight into how you are affected by the condition.


In which year were you diagnosed with DCM?

Have you had surgery for DCM?

Have you had physiotherapy for DCM?

Have you undergone any additional treatment for DCM?

How much does your DCM affect the function of your arms and hands?

(Please choose the statement that best describes your situation)

I am...


How much does your DCM affect your legs?

(Please choose the statement that describes your situation)

I am...


How much does your DCM affect the feeling in hands?

(Please choose the statement that best describes your situation)

I have...


How much does your DCM affect your ability to go to the toilet to urinate?

(Please choose the statement that best describes your situation)

I...


On average, how much pain do you experience with DCM?

Where 0 is no pain, and 10 is the worse pain imaginable.


Have you ever participated in a DCM research study before?

Your Employment Status


If you have any questions or concerns, please contact us via email:

admin@recode-dcm.com


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