Please help us to better understand the needs of individuals with incontinence by
filling out the following questionnaire.
Your responses will allow us to continue to design and create materials and resources that fit the most urgent needs of those with incontinence.
Click here to access the questionnaire. You can either:
1. Print it out, complete it and mail it to us.
2. Save the Word doc to your computer, complete the questionnaire, and then attach it to an email and return it to us at: email@example.com.
Thank you for sharing with us at The Simon Foundation for Continence. Your responses will be kept strictly confidential.
Page last modified 17 May 2012