Plot Your Health Reviewer Request Form
Hi! Thanks for your interest in trying our three-month tracking notebook designed for people with chronic illness. Please answer all the questions below and reach out to us with any questions or concerns at
Your full name *
Your answer
Your email address *
Your answer
Your Mailing Address *
Your answer
Where is your online presence? Please check all that apply. *
Please share your social media names, so we can link your request with your online presence. *
Your answer
Do you ever meet with a support group in person, or talk with other patients at your various doctor's offices? *
Would you be willing to share this product, and your experiences using it, with your doctor? *
By accepting a free copy from us, you agree to the following: to post pictures of your use online (you can blur personal info if needed), share your opinions with others, tag Plot Your Health using @PlotYourWork in your social media posts, use #PlotYourHealth in posts, fill out a survey after one month's use, and *to consider* (not required) writing a review on Amazon when the year-long version releases. *
Any comments or questions, please enter them below and one of our team will get back to you. *If you're requesting donations for care packages, please state so here with the name of your organization. (Limit of 12 per request)
Your answer
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