JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Surgical Seecrets™ Feedback Survey for Medical Professionals/Caregivers
This is for anyone who is a caretaker or medical professional whose care-recipient/patient has used our Seecret Undies™. Please fill out the survey below for a discount on your next pair!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
What is your name/title? (optional)
Your answer
How many total Seecret Undies™ did you buy/receive?
*
Your answer
How many patients have received this garment and how many did they purchase/receive?
*
Your answer
How did you hear about our Seecret Undies™ or Surgical Seecrets™?
*
Family or friends
Caretaker/medical professional
Other:
My patient(s) is/are using Seecret Undies™...
*
for post-operative care
because of a disability/lack of mobility
Other:
If Seecret Undies™ was used for post-op care, what surgery was it used after?
Your answer
Please rate your satisfaction with the following out of 5, with 5 being the most and 1 being the least.
*
1
2
3
4
5
Velcro design
Drain feature
Comfort
Ease of access
Quality of product
General satisfaction
1
2
3
4
5
Velcro design
Drain feature
Comfort
Ease of access
Quality of product
General satisfaction
What other colors would you like the garment to be in?
I like the white.
Black
Gray
Other:
Clear selection
Did you like the fabric? If no, how could it be better/what did you not like about it?
Your answer
How likely would you be to do the following:
Very unlikely
Somewhat unlikely
Neutral
Somewhat likely
Very likely
Buy this garment again in the future or in similar circumstances
Recommend this garment to someone you know
Very unlikely
Somewhat unlikely
Neutral
Somewhat likely
Very likely
Buy this garment again in the future or in similar circumstances
Recommend this garment to someone you know
Please tell us about your experience with Seecret Undies™.
*
What did you like about it? What could be improved? Is there anything else you would like us to know?
Your answer
Can Surgical Seecrets™ publish parts of your review onto our website?
*
Yes! Feel free to use my name.
Yes, but I would like to stay anonymous.
No.
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
