Assistive Technology of Ohio Customer Survey (2017-2018)
Please help us improve our services by taking this important (and brief) survey... Thank you!
Which device did you borrow? *
Your answer
What was the purpose of the device? *
Please indicate the reason which best applies
Required
Which category best describes the person who borrowed the device? *
Please indicate the description which best applies
Required
Which description of need best applies to your situation? *
Please indicate the description which best applies
Required
Which of the following best describes your decision regarding the device? *
Required
How would you rate your level of customer satisfaction? *
Please indicate the description which best applies
Please let us know how this service has helped you by telling us about your specific situation. (optional)
Let us know how this device will impact your life. (begin typing in box below)
Your answer
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