First name
Last name
Email
Country of Residence —Please choose an option—AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe
Your current level of education —Please choose an option—High school degree (=/>12 years of schooling)Bachelor’s degreeMaster’s degreeOther
Your previous education in P&O —Please choose an option—I have no education in P&O fieldISPO category II - Associate Prosthetist/OrthotistISPO category I- Professional Prosthetist/OrthotistOther
Where have you acquired your P&O education (please write the name of your school/university):
How much experience in P&O (working with patients) do you have? —Please choose an option—No experience in P&O (newcomer)Currently working in a P&O workshop, but less than 2 years of experienceCurrently working in a P&O workshop, with 2-5 years of experienceCurrently working in a P&O workshop, with over 5 years of experience
In your current job, do you work with patients on a daily basis producing prosthetic and/or orthotic appliances? YesNo
Which of Human Study programs are you interested in? —Please choose an option—Bachelor in P&O/Professional P&O Level ProgramAssociate P&O Level ProgramSCOPe CoursesOther
Why do you think this program would suit you best?
Are there colleagues close to you who have the same experience and qualification, who also want to study? If yes, how many?
Do you all work together at one location? YesNo
How did you hear about Human Study? —Please choose an option—From a student of Human StudyFrom social media (FB, Instagram, Twitter)From the Human Study websiteOther (please specify)
Is there anything else you think we should know?
