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1.Email Address(Required.)
2.In what country do you live?
3.How did you find out about Bloccs?(Required.)
4.Who did you buy a Bloccs waterproof protector for?(Required.)
5.If bought for child how old are they?
6.Which product(s) were used?(Required.)
7.What will the cover be used for?
8.Which hospital, clinic, doctors surgery or medical centre is currently doing the treatment?
9.Did the hospital, clinic, doctors surgery or medical centre provide you with information about Bloccs?
10.If your healthcare provider did not recommend us, would you suggest we let them know about our brand?
11.If you are in the UK, did you know our covers were available on prescription? (applies to people in the UK only)
12.Would you recommend Bloccs to a friend?(Required.)
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