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* 1. Please enter your name below

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* 2. Please enter city

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* 3. Please enter your speciality

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* 4. Date

Date
Time

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* 5. What is the average number of patients with hemorrhoidal disease (HD) which you treat in a month? (Please tick the appropriate option)

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* 6. Which of the following grades of HD you treat at your own clinic/hospital? (Please tick the appropriate option/s)

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* 7. What is the average number of patients you treat in a month for the following patient profile ? (Please put a number in the box given against all categories)

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* 8. In which profile of patients (from those given above), do you find Micronized Purified Flavonoid Fraction (MPFF) most useful? (Please write 2 patient profiles in the order of priority in the blanks given below)

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* 9. What are your 3 main reasons for prescribing MPFF in your patients with HD? (Please choose only 3 options and rank them in order in the given box)

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* 10. Do you agree with the statement that the MICRONIZATION process, involved in the manufacturing of MPFF, does influence the efficacy of MPFF in your patients with HD?

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* 11. The UNIQUE composition of MPFF, synergy of 5 flavonoids is responsible for the significant patient benefits of MPFF in your patients with HD. (Please mention your feedback below as a clinical expert)

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* 12. What is the average dose and duration of prescribing MPFF 1000mg in your patients with acute haemorrhoidal attack?

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* 13. What is the average dose and duration of prescribing MPFF 1000mg for prevention of relapses in your patients with recurrent / chronic haemorrhoids?

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* 14. Are you shifting to the new 1000mg of MPFF from 500mg for your HD patients?

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* 15. If no, what are your reasons (Please put a maximum of 3 reasons in the order of priority)

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* 16. On the scale of 1-10, how likely are you to recommend MPFF as the preferred treatment of choice in HD?

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