ANNEXURE I

QUESTIONNAIRE FOR PATIENTS / GENERAL PEOPLE

Dear Sir/Madam,

This is a survey to identify the customer needs and awareness for knee/hip joint replacement.
Please give your opinion on a scale of 1 to 7, where 1 implies very strongly disagree and 7 stands for
very strongly agree.

Q1. What is you age?

A. Below 25 B. 25 40 C. 40 60 D. 60 70 E. 70+

Q2. Which category of city do you live in?

A. Metro B. Tier I C. Tier II D. Tier III E. Village

Q3. Has anyone in your family/friends ever had a joint replacement operation?
A. Yes B. No

Q4. Are you aware of the conditions when joint replacement operations need to be done?
A. Yes B. No

Q5. Do you think your city has adequate facilities to carry out such operations?
A. Yes B. No

Q6. Do you think your city has qualified doctors/surgeons to undergo such treatment?
A. Yes B. No

Q7. Do you think such treatments are very expensive?

A. Yes B. No

Q8. What do you think is the approximate cost of such operations?

A. 1 - 3 lakhs B. 3 5 lakhs C. 5 7 lakhs D. 7+ lakhs

Q9. Do you have fear of undergoing such operations?

A. Yes B. No

Q10. Would you mind travelling to another city to undergo such operation?
A. Yes B. No