Answers provided will not be shared with other companies. Information is used for research purposes only. Question Title * 1. Email Address Question Title * 2. In what country do you live? Afghanistan Albania Algeria Andorra Angola Antigua and Barbuda Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia (Plurinational State of) Bosnia and Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cabo Verde Cambodia Cameroon Canada Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte D'Ivoire Croatia Cuba Cyprus Czech Republic Democratic People's Republic of Korea Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France Gabon Gambia Georgia Germany Ghana Greece Grenada Guatemala Guinea Guinea Bissau Guyana Haiti Holy See Honduras Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Lao People’s Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia (Federated States of) Monaco Mongolia Montenegro Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Qatar Republic of Korea Republic of Moldova Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka State of Palestine Sudan Suriname Swaziland Sweden Switzerland Syrian Arab Republic Tajikistan Thailand The former Yugoslav Republic of Macedonia Timor-Leste Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom of Great Britain and Northern Ireland United Republic of Tanzania United States of America Uruguay Uzbekistan Vanuatu Venezuela (Bolivarian Republic of) Vietnam Yemen Zambia Zimbabwe Question Title * 3. How did you find out about Bloccs? from a nurse from a GP or physician from a surgeon from a plaster technician from a physiotherapist from another medical worker (please specify in comment box below) from a friend or family member Online search from an article on Instagram on Facebook on Twitter Other (please specify) Question Title * 4. Who did you buy a Bloccs waterproof protector for? for my child for my grandchild for my partner for a family member for a friend for myself Other (please specify) Question Title * 5. If bought for child how old are they? 0-3 4-6 7-9 10-14 15+ Bought for an adult Rather not say Question Title * 6. Which product(s) were used? Adult Short Arm Adult Full Arm Adult Short Leg Adult Full Leg Adult Elbow Small Adult Elbow Medium Adult Elbow Large Adult Knee Small Adult Knee Medium Adult Knee Large Adult Knee Extra Large Child Short Arm Small Child Short Arm Medium Child Short Arm Large Child Full Arm Extra Small Child Full Arm Small Child Full Arm Medium Child Full Arm Large Child Short Leg Small Child Short Leg Medium Child Short Leg Large Child Full Leg Small Child Full Leg Medium Child Full Leg Large Child Elbow Extra Small Child Elbow Small Child Elbow Medium Child Elbow Large Question Title * 7. What will the cover be used for? Question Title * 8. Which hospital, clinic, doctors surgery or medical centre is currently doing the treatment? Question Title * 9. Did the hospital, clinic, doctors surgery or medical centre provide you with information about Bloccs? Yes No Question Title * 10. If your healthcare provider did not recommend us, would you suggest we let them know about our brand? Yes No Question Title * 11. If you are in the UK, did you know our covers were available on prescription? (applies to people in the UK only) Yes No N/A Question Title * 12. Would you recommend Bloccs to a friend? Yes, I already have Yes I would Possibly Probably not No Done