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Please answer each question.
Rating Scale:
5= Very Good | Very Comfortable | Very Soft
4= Good | Comfortable | Somewhat Soft
3= Neutral
2= Poor | Uncomfortable | Somewhat Scratchy
1= Very Poor | Very Uncomfortable | Very Scratchy
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| Which Version Are You Providing Feedback For? |
1
2
3
4 |
| Name: |
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| Hours Worn: |
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| During the testing you were mostly: |
Sitting
Sitting & standing
Standing
Moving a lot |
| Comments |
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| Shoes worn during testing? |
Business/Dress Shoes
Sneakers
High heals
Boots
Flip Flops |
| Comments |
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| How easy was the garment to put on? |
5
4
3
2
1 |
| Comments |
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| How easy was the garment to take off? |
5
4
3
2
1 |
| Comments |
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| How soft or scratchy did garment feel in your hand? |
Very soft
Somewhat soft
Neutral
Somewhat scratchy
Scratchy |
| Comments |
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| How soft or scratchy did garment feel when worn? |
Very soft
Somewhat soft
Neutral
Somewhat scratchy
Scratchy |
| Comments |
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| How did garment feel overall in your shoe? |
5
4
3
2
1 |
| Comments |
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| When worn, how did the garment make your leg feel? |
Hot
Warm
Comfortable
Cool
Cold |
| Comments |
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| How tight or loose was the garment on your leg? |
Too Tight
Normal
Too Loose |
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| How was the heel-placement of this garment? |
5
4
3
2
1 |
| Comments |
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| How did the toe box portion feel on this garment? |
5
4
3
2
1 |
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| Did you notice the knit in labeling in the toe box while wearing? |
Yes, no irritation
Yes, it irritated
No |
| Comments |
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| Following donning instructions, where did the top band of this garment rest on your leg? |
Bend of knee or 1" below
Above knee
Mid-calf |
| Comments |
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| During wear test, did the garment slide down at all? |
Never
Minimally
Yes, a little
Yes, a lot |
| Comments |
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| How far (inches)? |
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| If so,why do you think it slid down? |
Band too lose
Garment too lose
Garment too long
Garment too short
Other reason(explain) |
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| Other Reason/Comments: |
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| How was the overall length of this garment?(Knee-High) |
5
4
3
2
1 |
| Comments |
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| How comfortable was the top band? |
5
4
3
2
1 |
| |
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| How tight or loose was the top band? |
Extremely Tight
Somewhat Tight
Extremely Loose
Somewhat Loose
Neither Tight nor Loose |
| Comments |
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| Did the top band cause any irritation or leave markings? |
Yes, irritated and left marks
Yes, irritated but no marks
Yes, left marks but no irritation
No, neither marks nor irritation |
| Comments: |
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| Did the top band roll or fold down? |
Yes, rolled
Yes, folded
No, stayed flat |
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| If it rolled, please explain: |
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| Did the garment bunch anywhere, and you were not able to smooth it out? Please specify. |
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| Did the garment crease anywhere? Please specify. |
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| Did the garment rip anywhere during donning or while wearing? Please specify |
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| What was your overall satisfaction of fit & comfort for this garment? |
5
4
3
2
1 |
| Comments |
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| What did you like most about this product? |
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| If prescribed by a physician, would you wear this product? |
Yes.
No. |
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| If you answered NO, why would you not wear? |
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