1. Is your lymphedema in the upper extremity or the lower extremity?

• Upper
• Lower

2. At what age were you diagnosed with lymphedema?

• Under 20 years of age
• 25-35 years of age
• 35-55 years of age
• 55 years of age or older

3. How long ago were you diagnosed with lymphedema?

• Less than 5 years ago
• More than 5 years ago
• More than 10 years ago
• More than 15 years ago

4. How did you first know you had lymphedema?

• I was diagnosed by a physician.
• A friend or family member told me.
• I was told by another healthcare practitioner.
• I figured it out by myself by researching online or elsewhere.

5. If your lymphedema is due to lymph node removal or cancer surgery, did your surgeon or oncologist educate you on the risk factors of lymphedema or what to do about it?

• Yes
• No

6. If you have received lymph drainage therapy, including manual lymphatic drainage, were you taught a home self MLD program?

• Yes
• No

7. If you were taught a home self MLD program, would you say that you still reliably complete this program currently?

• Yes
• No

8. If you do not continue with your home MLD program, what is the reason?

• It didn't help.
• The routine was too complex and difficult.
• I can't reach to do the self massage.
• I don't have enough time.

9. If you stopped doing your MLD due to the complexity of the self MLD routine you were taught, was this routine:

• 5 or less steps or hand placements for the limb
• 5-10 steps or hand placements for the limb
• 10-15 steps or hand placements for the limb
• 15-20 or more steps or hand placements for the limb

10. Do you feel that your therapist spent enough time training you on your home self MLD and answered your questions about it?

• Strongly agree
• Agree
• Somewhat agree
• Disagree
• Strongly disagree

11. If you received compression bandaging in your lymphedema treatment were you taught how to self-bandage?

• Yes
• No

12. If you were taught how to self-bandage, are you able to still complete that task today when necessary?

• Yes
• No

13. If you were taught self-bandaging and cannot complete it today if needed, what is the reason?

• The cost of maintaining bandaging and materials is too high.
• I forgot how to properly bandage.
• I can't reach everywhere that needs to be bandaged.
• The bandage won't stay up and interferes with my activities or daily living.

14. Were you taught protective skin care of your at-risk limb?

• Yes
• No

15. If so, is the skin care program you were taught easy to maintain?

• Yes
• No
• I was not taught a skin care program.

16. If the skin care program you were taught is not easy to maintain, what are the factors that prevent you from maintaining a good skin care routine?

• Cost of supplies
• Can't reach the affected areas
• Takes too long to complete
• Other

17. Do you currently perform some sort of exercise to stimulate the muscle contraction in the at-risk limb?

• Yes
• No

18. If you answered yes, how many days per week and how many minutes per day do you complete exercises related to your lymphedema?

19. If you answered no, what prevents you from completing exercises related to your lymphedema?

• The exercises are too hard on me physically.
• I forgot how to do the exercises.
• I don't have enough time in the day.
• I wasn't taught exercises for lymphedema.

20. I was fit for a compression garment at the end of treatment when my measurements reached a plateau with compression bandaging and or manual lymphatic drainage.

• Yes
• No