1.

Your Name:

2.

E-mail Address:

3.

How old is your baby?

0 - 6 months

6 - 12 months

12 - 18 months

18 - 24 months

24 months plus

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4.

How severe is their eczema?

Occasional Flare-ups

Constant Irritation

Severe Eczema

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5.

What cleansing methods do you use at Nappy Change and after meal-times?

Cotton Wool & Water

Standard Baby Wipes

'Sensitive Skin' Baby Wipes

Organic / Herbal Baby Wipes

Other (please provide details)

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6.

How would you rate your current cleansing method in terms of a) Suitability for your childs skin?

Excellent

Very Satisfied

Satisfied

Could be Better

Very unsatisfied

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7. How would you rate your current cleansing method in terms of b) Convenience?

Excellent

Very Convenient

Satisfactory

Could be more convenient

Not very convenient

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8. How would you rate your current cleansing method in terms of c) Cost?

To assist with this question, 1 pack of pampers branded wipes per week over 2 years is £258. 

Scale upwards or downwards depending on how many packs of wipes you use per week and whether you buy branded or supermarket own brand.

Excellent (less than £60 over 2 years)

Very Good (£61 - £150 over 2 years)

Satisfactory (£151 - £250 over 2 years)

Could be better (£250 - £350 over 2 years)

Poor (£350+ over 2 years)

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9.

To take part in the test, you'll need to pay a £15 nominal fee. Should you decide at the end of the test period that you don't wish to continue using Cheeky Wipes, you can return the wipes and have your £15 refunded in full.

Would you like to be considered for this test?

Yes

No

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