1.

* 1. Did you watch the Preparing for Your Surgery Video?

* 2. How did you watch the Preparing for Your Surgery Video?

* 3. Who watched the video? (Check all that apply)

* 4. If a child watched the video, what was the age of the child?

* 5. How helpful was Preparing for Your Surgery in preparing YOU (parent/caregiver) for your child's upcoming surgery or procedure?

* 6. How helpful was Preparing for Your Surgery in preparing YOUR CHILD for the upcoming surgery or procedure?

* 7. Would you recommend Preparing for Your Surgery to others?

* 8. How would you prefer to receive information that helps you prepare for future appointments or procedures at Gillette? (Check all that apply)

* 9. What other topics would you like to see in video format?

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