Global Lead Apron Survey (GLAS)

7. In the past 12 months, have you had pain or discomfort in any of the following areas that you believe is at least partly related to wearing lead?

Rows	None	Mild (aware of it but not limiting)	Moderate (affects activity)	Severe (limits work or life)	Disabling (prevents work or major life tasks)
Neck
Shoulders
Arms (Shooting or radiating pain)
Upper Back
Mid Back
Lower Back

8. In addition to pain, have you experienced any of the following while wearing lead? (Select all that apply)
9. How often do you experience these symptoms or pain?
10. Because of pain or injury you attribute to lead apron use, have you sought any of the following? (Select all that apply)
Your Lead Apron
11. Have you been formally diagnosed with any of the following? (Select all that apply, optional)
12. Have you ever seriously considered leaving your specialty, reducing your practice, or retiring early because of lead-related pain?
13. Do you expect lead apron use to limit or shorten your career?
14. What have you tried to reduce or prevent lead-related pain? (Select all that apply)
What Your Body Is Telling You
15. Of the things you've tried, what has helped most (if anything?)
16. What is your age range?
17. What is your sex?
Impact on your life
18. Is there anything else you'd like to tell us that this survey didn't ask?
19. Would you like to receive information about our prototype program? Be the first to try our latest innovation and fight lead apron-related pain and injury.
20. If yes, please enter your email (kept private and never shared)
example@example.com
21. Full Name (optional)

First NameLast Name
Wants & Needs: What a Real Solution Looks Like
About You
Follow Up Preferences
Should be Empty: