Client Interest Survey

Thank you for your willingness to consider supporting us by transitioning some of the products you use on a daily and weekly basis. We have some big goals we are working towards. Being 100% debt free, purchasing a home, starting a family, being able to help our loved ones financially, etc. We are looking for a handful of loyal clients we can serve on a monthly basis with some of their everyday needs. Please fill this survey out to help us understand what sorts of items you would be open to discussing!
Name*
First NameLast Name
Email*
example@example.com
Home
Pet & child-friendly cleaning products. Multi-purpose cleaners, disinfectants, sprays, wipes, dish tabs, liquid and powder detergents, boosters, air purifiers, water filtration systems, cookware, etc.
Health
Top of the line multivitamins, supplements, workout products, weight loss, energy boosts, etc.
Beauty
Natural top of the line skin care, makeup, anti aging etc that is all healthy for your skin.
Personal Care
Hair care, body wash, shampoo, mouth wash, toothpaste, hand sanitizer, etc.
I am open to information about transitioning some basic personal products such as shampoo, toothpaste, mouthwash, etc. *

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am open to information about transitioning some basic home care products such as laundry, hand soap, dish soap, cleaners, etc. *

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am interested in information about having better nutrition in my diet. *

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am interested in information about having more energy. *

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am interested in information about on-the-go snack options . *

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am interested in information about help relieving aches and pains in joints and muscles. *

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am interested in information about helping improve the quality of my skin care regimen. *

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am interested in information about performance enhancing or recovery sports nutrition.*

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
I am interested in information about top of the line cookware.*

1 2 3 4 5
1 is Strongly Disagree, 5 is Strongly Agree
Select the item categories you feel you may have an interest in hearing about*
MultivitaminsEnergy SupplementsSports NutritionCleanersAir PurificationLaundryWater FiltrationEnergy DrinksWeight LossDaily basic skin careMakeupAnti-Aging ProductsSleep AidMeal ReplacementSnacksPersonal care
Any additional questions, needs, symptoms, or needs we may be able to help address?
(Optional)
Should be Empty:

Home

Health

Beauty

Personal Care