Zim Biosciences Breast Cancer Research Survey

Zim Biosciences Breast Cancer Research Survey

Please take a few minutes to tell us more about your experiences with your skin
At Zim were in development of a newly patented composition cream that's been found to be effective at accelerating skin healing with less redness, less pain and less scaring.

Our focus is with patients that have experienced breast cancer and not been satisfied with their skin condition, after surgery and/or radiation therapy.

We’re asking you to participate in this survey to help us optimize our understanding of your needs and make the best products available.
First Name only *
What's your gender? *

Female Male Non-binary Prefer not to answer
What's your age range?

0-17 18-24 25-34 35-44 45-54 55-64 65+
Your Skin Type
Your ethnicity (Asked because skin color changes how your skin reacts) *

American Indian or Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or Other Pacific Islander White Prefer not to say
Skin Issues
Has your skin experienced any of these issues ? *

Operation/s (surgery) Radiation treatment Other dermatology treatment/s or procedure/s Other
What type of skin treatment/s did you use ? *

Topical Medications (Dispensed by your physician) (creams/lotions/salves/etc.) Topical Medications (Prescriptions at a pharmacy) (creams/lotions/salves/etc.) Patch, bandage or dressing Over the Counter products (bought at a store)(creams/lotions/salves/etc.) No topical treatment (creams/lotions/salves/etc.) Other
What did you use on your skin and where ? *
Did the skin treatment work well 1-5 ? *

1

2

3

4

5

1 is Not effective, 5 is Awesome
What did you like or dislike about the product/s ?
What features would you like to have in a new product ? Don't hold back use your imagination..... you never know whats possible !
Is there anything else you want to tell us ?
Would you be wiling to be personally interviewed ? We have a few more questions, it's confidential, only takes ~5 minutes and be much appreciated.

Yes No
Your Email
example@example.com
You assistance with our study is REALLY helpful and gives Zim the answers we need to help others.... so a big .......Thank You!

If you'd like to keep up to date with our evolving products that will help with skin repair please click here and go to the bottom of the page, enter a few details and we will keep you informed.

Thanks again,

The Zim Team
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Zim Biosciences Breast Cancer Research Survey

Your Skin Type

Skin Issues

You assistance with our study is REALLY helpful and gives Zim the answers we need to help others.... so a big .......Thank You!

If you'd like to keep up to date with our evolving products that will help with skin repair please click here and go to the bottom of the page, enter a few details and we will keep you informed.

Thanks again,

The Zim Team