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This survey is generated by students from West Virginia University, and we are seeking to gather information about swallowing related to Parkinson's disease. We plan to use this data to help better identify what information about swallowing is being shared between doctors and their patients.
Please select below who is filling out this survey, then complete to the best of your ability.
Parkinson's Patient
Other
What is the month and year of your birth? (Example: 01/1941)
What's the month and year that you were diagnosed with Parkinson's diseases? (Example: 04/ 2020)
When did you first notice Parkinson's symptoms? (Example: 03/2018)
The following is a list of symptoms that may indicate a problem with swallowing. Please check any of these that you have experienced.
Subtle weight loss
Needing longer to finish eating a meal
Increased number of respiratory infections
A need to drink water with your food
Trouble starting or initiating the swallowing process
Choking while eating
Drooling
Difficulty chewing or avoiding certain textures
Pain while swallowing
Wet voice with food/drink intake
Frequent throat clearing
Feeling like something is stuck in your throat
Regurgitation of food
Heartburn/GERD
Are you aware that poor swallowing function can be a symptom of Parkinson's disease?
Yes
No
Has your doctor ever given you any information on swallowing following your Parkinson's diagnosis?
Yes
No
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