Sample Questionnaire
Age: Race or Ethnicity:
City or Town:
Occupation:
Type of Mobility Aid:
Hand propelled or electric:
Medical Condition requiring Mobility Aid:
What objects do you have trouble reaching:
Home:
Work:
Public places:
Your Height:
Your Weight:
If you use an electric mobility aid, how could the placement of the controls be improved?
if you use a wheelchair, how is it sized for you? (Too short, too tall, too wide, too narrow, etc.)
Have you ever had an injury attributable to your mobility aid? Please describe:
Return to Anthropometry For Persons With Disabilities
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Prepared for the
U.S. Architectural
& Transportation Barriers Compliance Board
Suite 1000
1331 F. Street
Washington, DC 20004-1111
Administered by the
U.S. Department of Education
400 Maryland Avenue, SW
GSA-NCR Building, Room 3660
Mail Stop 4448
Washington, D.C. 20202
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Under contract No. QA96001001
Prepared by
Shirley Kristensen
Bruce Bradtmiller, Ph.D.
Anthropology Research Project, Inc.
PO Box 307
Yellow Springs, OH 45387
22 August 1997
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