The Joy Player Consumer Feedback Survey

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* 1. Purchase date (month/year)

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* 2. In what setting (e.g., early childhood program, elementary school, home, adult day program, etc.) is the product being used?

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* 3. Describe the person facilitating the use of the product (e.g., classroom teacher, TVI, OT, PT, parent, etc.).

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* 4. Describe the learner using the product (e.g., 3-year-old with low vision and CP, 12-year-old with deafblindness, adult with light perception and autism, etc.).

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* 5. Rate the product's value.

5 = high

4

3

2

1 = low

5 = high

4

3

2

1 = low

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* 6. Comment on the product's value.

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* 7. Rate the product's design.

5 = high

4

3

2

1 = low

5 = high

4

3

2

1 = low

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* 8. Comment on the product's design.

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* 9. What is the learner's favorite activity when using the product?

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* 10. Provide any tips for using the product.

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* 11. Provide general comments on the product.