Survey Text

Survey form view entire document:  text  image
Hand Card M2.
Card M2
01 Leg brace
02 Foot brace
03 Arm brace
04 Hand brace
05 Neck brace
06 Back brace
07 Other brace
Aids for Getting Around
08 Crutches
09 Cane or walking stick
10 Walker
11 Manual wheelchair
12 Electric wheelchair
13 Scooter
14 Other aid for getting around
Hearing Devices
15 Hearing aid
16 TDD or TTY
17 Special alarms
18 Other hearing equipment
Vision Devices
19 White cane
20 Other vision aid, excluding glasses and contact lenses
Artificial Limbs
21 Artificial leg or foot
22 Artificial arm or hand
Other Devices
23 Aid for speech problems
24 Specially adapted typewriter or computer
25 Other devices for disabilities

Ask 5c and d for each person with "Needs equipment" in 5b.
c. What equipment does -- need?
Anything else?