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  • Topical AOTC Feedback Survey


    Your feedback is important to us & will help our research team improve Topical AOTC.

    The survey consists of questions in relation to your experience with Topical AOTC and takes no more than 5 minutes to complete. Upon successful completion of the survey we will send you a free bottle of Topical AOTC.
  • To begin the survey, please enter the password provided with your sample bottle of Topical AOTC.
  • Download & Print The Feedback Survey


    If you do not wish to take the online feedback survey, you can download the Topical AOTC Feedback Survey & submit the completed survey to survey@panagrx.com.

    Please Note


    The Topical AOTC feedback survey is currently limited to participants of the clinical trial and only one survey may be submitted per household. If you are having problems entering the survey or your password is not working, please contact us.
  • Step 1 - Personal Info

  • Step 1 of 10

    Your Personal Information & Contact Details

    Please provide your personal information & contact details.
  • Please enter a number from 18 to 99.
    All information collected by Panag Pharma Inc. will remain strictly confidential & held with regards to our privacy policy.
  • We're sorry, but in order to participate in the Topical AOTC survey & receive your free bottle of Topical AOTC, you must consent to sharing your Personal Information & Product Experience.
    Please contact us for more information.
  • Step 2 - Address Info

  • Step 2 of 10

    Your Address

    Please provide your address information so we can send you your free bottle of Topical AOTC.
  • Step 3 - Product Use

  • Step 3 of 10

    Product Use

    On average, how often do you use Topical A on a daily basis? Please select the option that best describes your average daily use of Topical AOTC:
  • Step 4 - Pain Relief

  • Step 4 of 10

    Pain Relief

    How well does Topical AOTC relieve your pain? Please rate the level of pain relief provided by using Topical AOTC by indicating the number that best describes your pain relief:
  • Step 5 - Treatment Satisfaction

  • Step 5 of 10

    Treatment Satisfaction

    How Satisfied Are You With Topical AOTC? Please select a number that best describes your level of satisfaction:
  • Step 6 - Treatment Irritation

  • Step 6 of 10

    Treatment Irritation

    Did you experience any irritation at the site of application from Topical AOTC?
  • Step 7 - Side Effects

  • Step 7 of 10

    Side Effects

    Did you experience any side effects from using Topical AOTC?
  • Step 8 - Product Applicator

  • Step 8 of 10

    Product Applicator

    Did you find the Topical AOTC applicator convenient?
  • Step 9 - Product Feel

  • Step 9 of 10

    Product Characteristics

    Was the Topical AOTC appealing to use? E.g. It wasn't overly greasy or had an offensive scent.
  • Step 10 - Additional Feedback

  • Step 10 of 10

    Additional Comments Or Feedback?

    Please let us know if you have any additional comments or feedback during your experience with Topical AOTC
  • This field is for validation purposes and should be left unchanged.
© Copyright 2018 - Panag Pharma Inc. | Privacy Policy
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