Welcome to the wipe survey.
You have to answer to the questions by checking your answer, or filling the blank space.
1. Do you wipe back-to-front, or front-to-back?
\[ \] Back-to-front \[ \] Front-to-back
2. Do you wipe while sitting, or standing?
\[ \] Sitting \[ \] Standing
3. After how many times do you stop wiping if the poo persists?
\_\_\_\_\_\_\_ times.
4. If there is no paper left to wipe, what do you do?
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
5. Do you wipe after you pee? (males only)
\[ \] Yes \[ \] No
6. If there is still poo on the paper, but you start bleeding, do you continue wiping until all the poo is erased?
\[ \] Yes \[ \] No
The Council wants to thank you for taking the time to answer to this survey.