Sleep Wellness Pre-Study Survey
Fill out this survey as best you can so that we can get an accurate reading of how you felt during and after the study.
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Email *
Who invited you to participate in the study? *
Name (First, Last) *
Age *
Phone Number *
Preferred method of contact (for check-ins and questions) *
What is your home address (For mailing the samples if necessary)
How often do you have trouble sleeping? *
What type (s) of sleep problems do you have?  *
How serious are your sleep problems when this occurs? *
How long has this been a problem? *
Are you willing to stick to the protocol and give honest feedback? The study requires you use the products consistently throughout the week for optimal results. Are you willing to do so? *
Have you watched the Pre-Study Orientation? Are you willing to view the wrap-up video (10min) at the end of the Study? (Required to receive incentive gifts) *
Please enter below, the code given during the overview:
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