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Seecret Apron™ Feedback Survey
This is for patients or anyone who has used our Seecret Apron™, our post-surgical drain pouch.
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* Indicates required question
What is your name?
*
Your answer
What was the date of your surgery?
MM
/
DD
/
YYYY
What date are you giving this feedback?
MM
/
DD
/
YYYY
What type of surgery did you have?
Your answer
How many drains did you have and where were they placed?
Your answer
What pattern was your Seecret Apron?
Pink Cancer Awareness Ribbon
Blue Floral
Clear selection
What size did you use?
Medium
Large
Clear selection
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 first initial and last name.
Yes! Feel free to use my initials.
No.
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