Skip to content
Crohns Disease Survey
Crohns Disease Survey
OK
*
1.
Do you have Crohns disease?
(Required.)
Yes
No
*
2.
How much has Crohns disease affected your life?
(Required.)
Minimally
Moderately
Significantly
I do not have Crohns disease
Describe how Crohns has affected your life
*
3.
Would you use an invisible and comfortable feeding tube for three months a year to reduce Crohns symptoms significantly?
(Required.)
Yes
No
*
4.
How do you treat your Crohns?
(Required.)
Steroids
Liquid diet
Immunosuppressants
Biological medicines
Surgery
Enteral feeding
No treatment
Other (please specify)
*
5.
How satisfied are you with your current Crohns treatments?
(Required.)
Not Satisfied
Moderately Satisfied
Very Satisfied
I do not have Crohns Disease
Other (please specify)
Current Progress,
0 of 5 answered