WinSanTor Peripheral Neuropathy Survey

11. Are you experiencing pain?

• Yes
• No

15. Would you recommend the physician you see to other neuropathy patients?

• Yes
• No

16. Are you interested in being contacted by WinSanTor to set up an interview?

• Yes
• No

17.  I have read the WinSanTor Privacy Policy. *This question is required.

• Yes

18. I understand that information I submit through this survey will be used by WinSanTor and participating clinical research sites to provide news, marketing and updates that may be of interest to me.  *This question is required.

• Yes

19. I consent to receive communications via email, mail or phone from WinSanTor and participating in clinical research sites *This question is required.

• Yes
• No