COUNTRY	PRE-IDENTIFIED BY IPSEN
INVESTIGATOR’S NAME	PRE-IDENTIFIED BY IPSEN (1 QUESTIONNAIRE PER PHYSICIAN)
INVETSIGATOR’S SPECIALITY	□NEUROLOGY	□REHABILITATION	□NEUROSURGERY
WHEN DID YOU TREAT YOUR 1ST CD PATIENT WITH BONT-A?	□	YEAR
DATE OF QUESTIONNAIRE COMPLETION	DAY MONTH     YEAR
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