LIVESTREAMSURVEY

LIVESTREAM
SURVEY

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FIRST NAME *

USERNAME / NICKNAME *

Email *

How did you hear about SEDATED MEDICAL? *

THROUGH SEDATED MEDICAL'S STAFF INSTAGRAM FACEBOOK FETLIFE TUMBLR TWITTER OTHER

If Other please specify: *

What is your age? *

18-25 26-35 36-50 Over 50 Prefer not to say

MEMBERSHIP TIER *

I'M NOT A PATIENT.... YET TRIAGE ER PRE OP OR ICU

NEW OR EXISTING PATIENT? *

HAVEN'T BECOME A PATIENT....... YET I AM NEW TO SEDATED MEDICAL I HAVE BEEN ADMITTED BEFORE I CAME AND NEVER LEFT

DO YOU ENJOY OUR LIVE STREAM VIDS? *

I AM IN LOVE WITH IT! I CUM FREQUENTLY I WILL COMMENT BELOW ON MY DESIRES I DON'T LIKE THIS CONTENT

ADDITIONAL CommentS *

TEAM MEMBER YOU SAW LIVE *

GASNURSEJEN / NURSE JEN OR DR. FOX DOCTORALEX / DR. ALEX ENEMADOM / DR. ED

COMMENTS FOR THIS TEAM MEMBER *

IS THERE A TEAM MEMBER YOU'D LIKE TO SEE MORE OF? *

GASNURSEJEN / NURSE JEN OR DR. FOX DOCTORALEX / DR. ALEX ENEMADOM / DR. ED

ANY OTHER COMMENTS / SUGGESTIONS YOU MAY HAVE: PLEASE BE AS DETAILED AS POSSIBLE *

SUGGESTIONS FOR NEW CONTENT OR UNEXPLORED KINKS *

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