Kinevate™ Post-Wear Survey

About 90 seconds. This wraps up your test period — thank you for sticking with it.

Your info

Tester ID

Pre-filled from your invitation link — this can't be changed.

Email address

Falls during the test period

How many falls did you experience during the test period?

Please briefly describe what happened and whether you were injured

Please add a brief description.

Changes during the test period

Did you change any other treatments (medication, PT, etc.) during the test period?

Yes No

Please briefly describe the change

Please add a brief description.

Where you ended up

Which of the following do you currently experience? (check all that apply — at least one required)

Unsteadiness while walking Difficulty on stairs Shuffling or shortened steps Fear of falling None of these

Please select at least one option.

Ending confidence

Same six questions as before — please answer based on how you feel now, after wearing Kinevate™.

BUILD NOTE: The six items below are placeholders. Exact published wording must come from the validated-instruments owner and must match prewear-survey.html word-for-word. Remove this banner only after the real wording is in and verified identical in both files.

ABC6-PLACEHOLDER — item 1 of 6

0% confident100% confident

ABC6-PLACEHOLDER — item 2 of 6

0% confident100% confident

ABC6-PLACEHOLDER — item 3 of 6

0% confident100% confident

ABC6-PLACEHOLDER — item 4 of 6

0% confident100% confident

ABC6-PLACEHOLDER — item 5 of 6

0% confident100% confident

ABC6-PLACEHOLDER — item 6 of 6

0% confident100% confident

Sharing your feedback

We'd love to share parts of your experience. What are you comfortable with? (check all that apply — at least one required)

Quote me, first name only Quote me anonymously Use my star rating only, no quotes Please don't share my feedback

Please select at least one option.

Anything you'd like to share in your own words? (optional)

Questions about the beta? Reply to any of our emails or contact marketing@kinevate.com.