Mentor answering for Mentee Survey July 21 Since you received your shipment from the CAP Program how satisfied are you with your machine and/or supplies? Select Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied How satisfied are you with the CAP Program? Select Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied Did you receive previous training to use your PAP therapy? Yes No How many nights/week are you using your therapy? Select 1 2 3 4 5 6 7 How many hours/night are you using your therapy? 1 2 3 4 5 6 7 8 9 Have you seen improvement to your health since using the therapy? Yes No Not sure How often do you clean your machine/supplies? Select Daily Weekly Monthly If patient is willing Demographics: Select Yes No Height Height (ft) ft Height (in) ft Weight lbs Race/ethnicity Birth Year Gender Would you be interested in becoming a Mentor or are you in need of a mentor? Select Yes, I'm interested in becoming a mentor Yes, I'd like to become a mentee with an assigned mentor No Comments Submit Δ
