We are so happy that you are a part of the FreeArm Family!

We would love to hear how tube feeding is going now that you have been using your FreeArm for several months! If you have 5 minutes to complete this form, we would greatly appreciate it! Thank you from the bottom of our hearts!

Name

First Name

Last Name

State

Age of person with feeding tube or port

Check all that you currently use

G-tube or GJ-tube

NG-tube or NJ-tube

Port

Other (please explain)

If you selected "other":

Check all that you currently use

Pump feeds

Gravity syringe feeds

Infusions

Other (please explain)

If you selected "other":

How many days per week do you use your FreeArm?

How have your feelings about having a feeding tube or port changed since using your FreeArm?

How has your ability to travel or attend appointments during feeds and infusions changed, if any, since using your FreeArm?

How has your confidence with tube feeding and infusions changed, if any, since using your FreeArm?

Have you had any issues with your FreeArm that caused you to need a repair or replacement? If yes, did you reach out to us and was your problem resolved?

How is your overall experience using your FreeArm? Do you have a 2-3 sentence testimonial about how the FreeArm has possibly made tubie life a little less complex? Your testimonial may be shared in our monthly newsletter, so keep a look out to see if you are featured!