Dr. Nick is very interested in knowing some facts about his patients. So please fill out the following form. Thank You!
 (If desired Dr. Nick will publish the results of the statistic poll in some future time.)



your age (in years):

your sex:

city:

area:

country:

how often have you been on Dr. Nick's page:

how many questions have you left:

if you left any, did you like the answer(s):

where from did you first encounter Dr. Nick's practice:

if it was a search engine, which one was it:

if not listed, which one was it:

if it was a homepage, which one was it:

what browser are you using (e.g. Netscape 3.0):

do you like the outfit/style of the page:

do you like the style/content of the answer(s):

I find the answers are:
funny boring offensive very very disgusting
plus they are:

here you can leave general comments
(like: "I miss ...", "Dr. Nick should improve his ...", ...):

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