Supporter Demographics

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 and the person you support are affected by the condition.


Your Employment Status

In which year were they diagnosed with DCM?

Have they had surgery for DCM?

Have they had physiotherapy for DCM?

Have they undergone any additional treatment for DCM?

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

Please choose the statement that best describes the situation of the person you support.

They are...


How much does DCM affect their legs?

Please choose the statement that best describes the situation of the person you support.

They are...


How much does DCM affect the feeling in their hands?

Please choose the statement that best describes the situation of the person you support.

They have...


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

Please choose the statement that best describes the situation of the person you support.

They...


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

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


Is the person with DCM that you support currently employed?

Have you ever participated in a DCM research study before?


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

admin@recode-dcm.com


 
 
 
 
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