ICA Update Winter 2010 Feedback Survey
Questions that require an answer are marked with  *
   
1 Age
   
   
2 Sex
   
   
3 Race
   
   
4 State
   
   
5 Country (if not from the USA)
   
   
6 Zip Code
   
   
7 Do you have IC?
   
   
8 If yes, how long ago were you diagnosed?
   
   
9 Are you a member of the ICA?
   
   
10 Do you receive the ICA Update?
   
   
11 Did you read the Winter 2010 edition of the ICA Update?
   
   
12 Did you find the information in this edition of the ICA Update helpful?
   
   
13 After reading this edition of the ICA Update, how likely are you to discuss pain management with your healthcare provider?
   
   
14 Do you have any comments about this edition that you would like to share with us? (256 max characters)
   
   
15 What kinds of articles would you like to see in an upcoming edition of the ICA Update? (256 max characters)