Take the Survey

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Thank you for your interest in taking the Hysterectomy Surgical Survey. You will be asked to create a PIN, this will only be used in my own database to identify your information. By providing this, in the future if you wish to have your surgery survey response removed from this site, I will have the information to verify which response was yours so that I can delete it from the website and my database. I will not delete any information without verification of the PIN that was given in the survey itself. If you agree to these terms, please click the button below to take the survey. Thank you.