Application 7 Survey

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Application 7 Market Survey

NAME OF SPONSOR COMPANY: PeriphEX Corp.

STUDY ADMINISTRATOR: Disruptive Engagement

We hope that you enjoyed your seventh NoxyPure application. Please answer the survey questions below. Thank you.

Name
First Last
Please rate your level of pain after 7 treatments.
No pain Mild pain Moderate pain Extreme pain
How would you describe your experience using NoxyPure for pain relief so far?
- Extremely Positive
- Positive
- Nuetral
- Negative
- Extremely Negative
How does NoxyPure compare to other treatments or medications you have tried?
- Much Better
- Slightly Better
- Neutral/Same
- Slightly Worse
- Much Worse
Is there anything else you would like to share?
Please add any additional thoughts, questions, or feedback you have after your 7th treatment.
Please describe how your NoxyPure experience is so far.