Ancient Remedies Customer Survey
Submit your comments, concerns, or other feedback below for 10% off your next purchase!!


*Feel free to skip any questions you don't want to answer, however, you must provide your full name and feedback to qualify for the 10% discount. Offer cannot be combined with other sales or discounts except Medical Pricing.

Full name:
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Date of your visit:
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Time of your visit:
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The name of the employee who helped you:
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