Survey of Fast Forward Early Intervention OM App with Pediatric Belt Canes

Safe Toddles, Inc
www.safetoddles.org
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Fast Forward Early Intervention Orientation and Mobility Curriculum will be paired with a smart belt connected to a pediatric belt cane (wearable white cane).
For more information about Fast Forward Early Intervention Orientation and Mobility curriculum with Pediatric Belt Canes go to: https://drive.google.com/drive/folders/1gFHlfLpaxMOBsksp_899FRswx6G8xIq7?usp=sharing  

Please answer the questions below about your interest in obtaining the curriculum for assisting you to include the pediatric belt cane into the daily routines of a child who is blind or mobility visually impaired.

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* 1. In what country do you reside?

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* 2. Are you a: (select one or more)

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* 3. Years of experience with blindness and visual impairment?

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* 4. Do you have experience working with toddlers (aged 11 months to 3 years) with severe visual impairment?

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* 5. If yes, please indicate approximately how many years of experience you have working with toddlers (aged 11 months to 3 years) with severe visual impairment?

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* 6. What was your first reaction to pediatric belt cane?

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* 7. If Fast Forward EI OM Smart Belt App were available today, how likely would you be to buy The EI OM App Smart Belt pediatric belt cane?

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* 8. How likely are you to replace your current mobility method for toddlers who are blind with The Fast Forward EI OM app with pediatric belt cane?

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* 9. How would you like to receive additional information about the Fast Forward EI OM curriculum and smart belt pediatric belt cane?

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* 10. How likely is it that you would recommend Fast Forward EI OM with pediatric belt cane to a friend or colleague?

Not at all likely
Extremely likely

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* 11. Please add any further comments here (optional):

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