* 1. As part of this survey, Everviolet, Inc. is requesting some general medical information from you in order to better understand the needs of women who have undergone breast surgery for cancer or other reasons. 

This information will be used solely for the purpose of researching, developing, and marketing Everviolet goods and products, and will be treated by Everviolet as strictly confidential and anonymous. The information will not be shared with anyone else, other than in accordance with Everviolet's privacy policy, which may be updated periodically. 

Please click "accept" to indicate your understanding of and consent to the use of this medical information, as described above.