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Neuraptine Clinical Data Survey
Welcome!
Thank you for scanning in to see us. Below is a very short survey that will help us find new ways to improve, and to help make your life better. We sincerely value your feedback!
* Indicates required question
Email
*
Your email
Your Name
*
Your answer
1. What is your age group?
*
20-30
30-40
40-50
50-60
60+
2. What is your gender?
*
Female
Male
Prefer not to say
3. What body part did your physician prescribe Neuraptine for?
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Knee
Shoulder
Wrist
Elbow
Back
Other:
4. How effective is the cream in helping with your pain and aches?
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Very Effective
Effective
Somewhat Effective
Not effective
5. Have you experienced relief after applying the cream?
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Yes
No
6. How soon after applying the cream do you experience relief?
Immediately
Within the hour
Between 1-2 hours
Other:
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7. How often or how many times per day are you applying the cream according to your physicians direction?
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1-2 times per day
3-4 times per day
5-6 times per day
8. On a scale of 1-5, with 5 being most likely, would you recommend Neuraptine to a friend if their physician prescribed it?
*
Not at All
1
2
3
4
5
Absolutely
If you have any comments or testimonials, please let us know below!
Your answer
Would you like to be on our mailing list? Your information will be kept private, never sold, and used solely for you to be updated about Neuraptine.
Yes
No
Clear selection
Would like a free gift card? (If answering yes, a gift card will be sent through email within the next few weeks)
Yes
No
Clear selection
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