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Wheelchair Doorkeeper

Page One

1. Are you currently a wheelchair user? *This question is required.
2. If you answered No, have you ever used a wheelchair before?
3. How many years have you used a wheelchair?
4. What is your Gender?
5. Do you ever experience difficulty passing through doors in a wheelchair?
6. Have you ever experienced difficulty helping a wheelchair user pass through a door?
7. What would you rate the difficulty of passing through a door on a scale of 1 to 5. (1 easy -5 hard)
Please read the excerpt below describing new wheelchair accessory.
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8. If this product was available what is the likelihood you would use it?
9. Would you purchase this product for a friend, family member or yourself?
10. How much would you be willing to pay for this product?
11. How many persons do you know that would be interested in the product?
12. New Radio Button Question