🔍 Urinary Incontinence Survey

First Name (Optional)

Last Name (Optional)

Email (Optional)

Demographics (Optional)

What is your gender?

Male

Female

Prefer not to say

Incontinence Product Usage

Do you currently use any products to manage incontinence? *

Yes

No

Lifestyle and Activity

Has incontinence affected your willingness to attend social events (parties, dining out, etc.)? *

Yes

No

Do you feel confident in public wearing incontinence products? *

Yes

Sometimes

No

Has incontinence negativly affected your emotional well-being or mental health? *

Yes

Sometimes

No

Have you ever avoided leaving home due to fear of leakage or accidents? *

Yes

No

Final Questions

Would you be open to trying a new type of incontinence product designed specifically for comfort and discretion? *

Yes

Maybe

No

How important is discretion (invisibility under clothes, silent use, odor control) in your choice of incontinence product? *

Very important

Somewhat important

Not important