1. What kinds of equipment do you use to treat your patients? (Check all that apply)
Sharps (Syringes, Needles, IV's)
Medications in liquid form
Medications in pill form
Any Other Equipment?
2. Where do you treat patients?
In the Home
In a Hospital
A Private Practice
Other (please specify)
3. Where do you feel the safest when you are treating patients?
In the Home
In the Hospital
A Private Practice
I do not feel safe at all
Other (please specify)
4. If you do not feel safe, Why?
5. Which place do you feel is the cleanest while you are treating patients?
In the Home
In the Hospital
A Private Practice
I do not feel clean at all
Other (please specify)
6. Do you feel the safest in this clean place?
7. If you do not feel clean, Why is that?
8. Please rate these questions in terms of treating patients in the home. (1) Very Convenient, (2) Somewhat Convenient, (3) Slightly Inconvenient, (4) Very Inconvenient, (5) Equipment travels conveniently.
Equipment travels conveniently.
Equipment is accessed conveniently.
Disposal of equipment after use.
9. When you are done with the equipment what do you do with it? Please give a specific example.
10. What kinds of equipment do you dispose of and where do you dispose of them?
