PLEASE LET ME KNOW VIA THIS QUESTIONNAIRE
WHETHER OR NOT YOU HAVE BEEN HELPED BY 
THE INFORMATION PROVIDED VIA THE WEBSITE



Dear Reader,	

I hope all given information is of benefit to you, as it was to me. 
To be able to further improve this website, I would like to know what you think of the information as it is provided. Your feedback will be welcomed, as it will allow me to improve both website and book - and make it a truly informative and complete work on healing fibroids, on all levels.

Thank you,
Irma Roskam - editor 



INSTRUCTIONS
This document is a regular Text-document and can be edited in any text editor.
1. 'Copy & paste' the text below, between the ********* dividers, into your own text editor   
   (e.g. Word, Word Perfect, Simple Text, or directly in your E-mail) 
2. Complete it by placing the cursor on the appropriate line or field to fill out the details.
3. Save it as plain text (.txt) document, naming it: Questionaire_by_my_name.txt
   (include your name in the new filename), so I know who's questionnaire it is.
4. E-mail it as an attachment to:  editor @ fibroidsolutions . com
	
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NAME:                                                     
AGE:                                            
ADDRESS:                                   
EMAIL:                          

1.  How did you find out about this website
[ ]  Internet Browser 
[ ]  Leaflet
[ ]  Magazine
[ ]  Newspaper
[ ]  GP 
[ ]  Gynaecologist
[ ]  Someone told me
[ ]  Other:

2.  Which PDF-texts did you download and read
[ ]  A1: Fibroid Tumours of the Uterus
[ ]  A2: More about fibroids - Your Questions Answered
[ ]  B1: Hysterectomy - Why Not?
[ ]  B2: Uterine Fibroid Embolisation - Keyhole Surgery with X-Ray Vision
[ ]  B3: Fibroids & Fertility
[ ]  Preface - My Story

 	 * I would like to read the additional chapters that are not yet available, especially:
		[ ]  Fibroids & Emotions
		[ ]  Other Treatment options
		[ ]  Complementary Therapies
		[ ]  Myomectomy

3.  I found the quality of the information to be...
[ ] ...more informative than most other information I read so far on fibroids and their treatment.
[ ] ...equally as informative as most other information I read so far on fibroids and their treatment.
[ ] ...less informative than some of the other information I read so far on fibroids and their treatment.

 	* Comments: [please fill in or add at bottom] ......

4. Was it easy to navigate around the website:
[ ] Yes 
[ ] No

 	* And did you find what you needed to know:
		[ ] Yes 
		[ ] No

 	* Comments or suggestions: [please fill in or add at bottom] ......

5. Would you prefer to read medical information in book-form
[ ]  Yes, I'd rather read a book, and would be willing to buy it if the price was reasonable.
[ ]  I would prefer to download an economically priced E-book, rather than separate pdf-files. 
[ ]  I prefer to be informed via the internet. To keep a website like this online, I would not mind 
     to pay a small fee for good pdf texts - provided I can read a summary first.
[ ]  I think all information about fibroids should be provided free on the internet.

6. What will likely be - or has been - your choice of treatment:
	 Treatment:
	 Date:

 	* Please consider sharing your own story with other patients; 
 	  go to the Forum & Contact page on the website.

7. Is there anything that is not discussed that you would like to see added on the website:


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Email: editor@fibroidsolutions.com 
Irma Roskam
273 Mt. Burrell Rd.
Mt. Burrell NSW 2484 - Australia

(c) 2004 http://www.fibroidsolutions.com