1.Are you male or female?

Male

Female

I don't identify as either or prefer not to answer.

2.Which type of treatment did you have?

TIF, EsophyX or c-TIF

MUSE

GERD-X

I don't know

3.Please indicate below any symptoms you regularly experienced before your intervention

THROAT: Hoarseness, sore throat, loss of voice or throat clearing

CHEST: Chronic cough or asthma like symptoms

NOSE: Post nasal drip, poor sense of smell, sinustitis or catarrhal symptoms

THROAT: Globus (feeling of lump in the throat)

MOUTH: Tooth erosion

MOUTH: Bad breath or bad taste in mouth

EYES: Dry or gritty eyes

EARS: Waxing, Glue Ear, Tinnitus or dizziness

4.Please indicate below any symptoms you regularly experienced after your intervention.

THROAT: Hoarseness, sore throat, loss of voice or throat clearing

CHEST: Chronic cough or asthma like symptoms

NOSE: Post nasal drip, poor sense of smell, sinustitis or catarrhal symptoms

THROAT: Globus (feeling of lump in the throat)

MOUTH: Tooth erosion

MOUTH: Bad breath or bad taste in mouth

EYES: Dry or gritty eyes

EARS: Waxing, Glue Ear, Tinnitus or dizziness

5.How long ago did you have your surgery?

Within the last 6 months

6 months to a year

More than a year

6.Are you happy you had the treatment?

Yes

No