Customer Satisfaction Survey

1. The uresta® bladder support helped my stress incontinence.: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

2. The uresta® bladder support stopped my urine leakage.: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

3. The uresta® bladder support is easy to use.: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

4. The “Instructions for Use” booklet was easy to read & understand.: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

5. I am satisfied with my uresta® bladder support: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

6. I am satisfied with the product information on the uresta® website.: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

7. When I phoned or emailed for help, I received it in a timely fashion (within 72 hours).: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

8. I would recommend the uresta® bladder support to family or friends.: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

9. The uresta® bladder support was easy to obtain.: *

I Strongly Disagree, I Disagree, I don’t agree or disagree, I Agree, I Strongly Agree, Does Not Apply to me

11a. Did your health insurance cover your uresta® bladder support?: *

Yes

No

12. How did you hear about the uresta® bladder support?: *