User survey InsuJet™
Dear InsuJet™ user,
Since 2010, the InsuJet™ needle-free injection system is available in several countries. Naturally, we hope that you are as excited about the system as we are. In this survey, you can share your experiences with us.
By filling out the questionnaire below, we are able to learn more about you, as an InsuJet™ user, and what you think should be improved about the system. Of course, all your answers are processed anonymously and will not be traceable to the person.
Your input is of great importance for the continuous improvement of the InsuJet™ system. That's why we'd love to hear from you!
The InsuJet™ team
Younger than 15 years
Between 15 and 24 years
Between 25 and 34 years
Between 35 and 44 years
Between 45 and 54 years
Between 55 and 64 years
What type of diabetes do you have?
Type 1 (genetically determined, from a very young age)
Type 2 (old age diabetes, got it later in life)
I don't know
Which insulin pen did you use previously? (If applicable)
When did you start administer insulin?
Please specify month and year (approximately)
Which type of insulin do you use?
Humaline ® 30/70
Humalog ® Mix 25
Humuline ® NPH
Humuline ® Regular
Insuman Basal ®
Insuman Comb ® 15,25,50
Insuman Rapid ®
Mixtard ® 40,50
Novomix ® 35,50,70
How many times per day do you administer insulin?
How many units do you administer with the InsuJet™ in the morning? (if applicable)
How many units do you administer with the InsuJet™ in the afternoon? (if applicable)
How many units do you administer with the InsuJet™ in the evening? (if applicable)
Before using the device for the first time, did you read the included instructions for use booklet?
Before using the device for the first time, did you watch the online instruction video?
Did you receive an individual training session from a Diabetes Care Specialist?
On a scale from 1 to 10, do you think the available InsuJet™ instruction material is sufficient to learn how to use the system?
Do you have any comments or suggesions regarding the instruction material?
How do you experience using the InsuJet™ in general?
What do you consider the most important advantage(s) of the InsuJet™ system?
What do you consider the most important disadvantage(s) of the InsuJet™ system?
What has been the main reason for you to start using the InsuJet™ system?
Would you recommend the InsuJet™ to another patient?
Please indicate why you would or would not recommend it
Do you have any suggestions or recommendations to further improve the InsuJet™ system?
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