1.What is your first name?

2.What is your last name?

3.What is your email?

4.What is your company's name?

5.What is your title?

6.Which, if any, period products are provided in your office?

7.Are you aware of any HR policies around menstrual leave or rest at your company?

No

Yes (please specify)

8.Would menstrual benefits impact your willingness to stay at your current company? (e.g., period leave, period rest, access to doctors and therapists to address menstrual symptoms)

Yes

No

Unsure

9.Would you like to be added to our waitlist to learn more about our products and services?

Yes

No

10.Is there anything else you would like to share?