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 plotyourhealth@plotyourwork.com
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. *
Required
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
Submit
Never submit passwords through Google Forms.
This form was created inside of Red Hot Publishing. Report Abuse - Terms of Service