Receive More Information About Gastric Electrical Stimulation for Gastroparesis

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9. I am a:  Patient
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   Please answer the following questions so we can better understand how to help patients:
10. Have you been diagnosed with chronic nausea and vomiting secondary to gastroparesis? Yes
    No
11. How long have you been diagnosed? 0-1 years
    2-3 years
    3 + years
12. What is the origin (etiology) of your gastroparesis? Idiopathic
    Diabetic
    Other**
13. What kind of physician are you seeing for your gastroparesis? Gastroenterologist
    Endocrinologist
    General, PCP (primary care physician), family physician
    Other

* Items marked by an asterisk are required.

**Enterra Therapy is not indicated for patients with gastroparesis resulting from other causes.

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