Name *

First Name

Last Name

Occupation: *

Occupational Therapist

Physiotherapist

Student

Other

What is the patient/client population you serve? *

Paediatrics

Geriatrics

Bariatrics

Early Intervention

Community Setting

Specialised Centre

How long have you been a practicing professional? *

0-1 years

2-5 years

6-10 years

11+ years

How long have you been involved in wheelchair and seating provision? *

0-1 years

2-5 years

6-10 years

11+ years

How much education and training did you receive regarding wheelchair and seating service provision during your professional training? *

I did not receive any education or training on wheelchair service provision.

I received a basic amount of education and training on wheelchair service provision but do not feel that it was enough for me to provide effective solutions for the individuals I work with.

I received a basic amount of education and training on wheelchair service provision and do feel that it was enough for me to provide effective solutions for the individuals I work with.

I received a good amount of education and training on wheelchair service provision and feel confident in my skills and knowledge regardless of the complexity of the postural and functional presentation.

Have you attended a seminar or workshop held by Sharon Sutherland or Dr.Jennifer McKee in the past? *

Yes

No

What are your goals for this mentorship programme? (check all that apply) *

Review anatomy and biomechanics as it relates to seating and lying

Increase confidence with hands on assessment skills

Conduct joint assessments together virtually

Increase ability to translate clinical findings to technology parameters /solutions

Discuss aspects of current cases that are challenging

Understand how to use/interpret outcome measures

Increase knowledge of available related research /evidence publications