Ergonomics Survey
 
 
Registrar: Clint Goss
Phone: 203-454-1479
Fax: 203-222-0895
Email: clint@goss.com
6 Fieldcrest Road
Westport, CT 06880

Secure Survey Form
This survey form is protected by Secure Socket Layer (SSL) strong encryption.
All information entered here is private and secure.
 1 » Your Information

First Name:

Last Name:

E-mail address:

 2 » Details
Your age:
Your height: feet and inches (if appropriate, add: .25 for ¼″, .50 for ½″, .75 for ¾″)

Sex    Female    Male    It's Complicated

Time playing any wind instrument: years and months
Experience playing Native flutes:    Beginner    Novice    Intermediate    Advanced
Time playing Native American flutes: years and months

 3 » Health Issues
Relevant health issues (particularly involving muscles, joints, bones, or nervous system):
Arthritis::    None    Mild    Moderate    Severe
Osteoporosis:    None    Mild    Moderate    Severe
Gout:    None    Mild    Moderate    Severe
Physical trauma (arm, hands, or neck – please provide details)
Neuromuscular disease (please provide details)
 
      Other health issues:
      
 
      Details on any of the above:
      

 4 » Survey
Using the scale above, what is your
maximum level of physical discomfort you experience when playing Native flutes
:
   0    1    2    3    4    5    6    7    8    9    10
 
Using the scale above, what is your
average level of physical discomfort you experience when playing Native flutes
:
   0    1    2    3    4    5    6    7    8    9    10

What percentage of time do you experience any level of physical discomfort when playing Native flutes: %
 
      Please describe any particular issues regarding discomfort playing flutes,
      or any other information you feel is relevant:
      

 

 5 » Submit Survey
 

When you are done, please click:
 

 

Notes
  • Thank you for completing this survey! We hope it will shed some light on the issues that some players experience when playing their flutes.
  • Please submit only one survey (per person).
  • We ask for your name only to confirm that we are receiving survey results from distinct people.
  • We collect your email address in the rare case that we need to ask for addition information.
  • For more information on this research study, please visit the Ergonomics Survey page.