| Please circle the number that you feel most reflects your view. | ||
| 1. Would you rate this experience as: | ||
| Unsatisfactory |
|
Very Satisfactory |
| 2. How would you rate your likelihood of pursuing the study treatment in the future? | ||
| Very Unlikely |
|
Very Likely |
| 3. Did you receive the study treatment? | □Yes | □No |
| If yes, how comfortable would you rate this treatment? | ||
| Very Uncomfortable |
|
Very Comfortable |
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