Potential Customer Survey... How may I help you live your best life? Let's Begin with a few questions...
Name (First and Last)
Age Group (Select one category from the drop down)
18 - 25
26 - 35
36 - 45
46 - 55
56 - 65
In general, do you feel healthy and equipped to live the life you desire (without physical or health limitations)?
Based on your above answer, what areas, if addressed, would help you to live a better life, health wise?
Vision/Eye Health (i.e. blurry vision, dry eye, cataracts, etc.)
Energy and/or Focus
Brain Health (i.e. Memory, preventive care, etc.)
Women's Wellness (i.e. Menopause, PMS, etc.)
Other (please explain below)
Other areas of health & wellness concern:
Do you currently take vitamins and/or supplements?
No, and I am not interested in vitamins/supplements.
No, but I am interested in vitamins/supplements.
Do you exercise?
Do you have any concerns with your workouts? Select all that apply.
Energy and/or focus (before and/or during workout)
I do not have any workout concerns
Do you prefer to eat, drink, or take a tablet to help with a need?
I prefer to EAT products to help with a health need
I prefer to DRINK products to help with a health need
I prefer to TAKE A TABLET (OR GUMMY) to help with a health need
Do you have children (ages 4-12)? If so, are you interested in learning about children's vitamins?
Yes, and I would like more information about children's vitamins.
Yes, but I am not interested in this information.
I do not have children in this age group.
When you go to a store (online or in person) what determines if you buy a product or not? Select all that apply.
Naturally Sourced (Eco-friendly, natural ingredients, all-natural, "green", etc.)
Meeting an Essential Need
Are you open to exploring and learning more about naturally-sourced, high quality brands to potentially switch to from brands you are more familiar with and/or currently use?
If so, in which product category are you willing to try new brands? (Select all that apply.)
Vitamins and Supplements
Natural Energy Drinks
Weight Loss Management
Body Care (i.e. Lotion, Body Wash, etc.)
Wellness and Exercise Essentials (i.e. Pre- and Post-Workout Products, Protein Shakes, etc.)
Home Essentials (i.e. Laundry Detergent, Dish Soaps, Home Cleaners, etc.)
May I contact you by email or phone with any health and/or wellness products that I have to assist you, based on your survey responses?
Yes (I prefer a phone call)
Yes (I prefer an email)
No, thank you!
If you wish to be contacted by phone, please include your phone number.
Send me a copy of my responses.
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