Post Detox Program Questionnaire
Name
First Name
Last Name
Email
example@example.com
What were your pre and post toxicity questionnaire scores?
*
Did you experience any weight changes during the program?
*
Did you experience any blood sugar, blood pressure changes with the program. If so, please elaborate ie: my BP has dropped 10 points after the program etc.
*
Please rate the following categories by checking the appropriate box:
Information content of program
Poor
1
2
3
4
Great
5
1 is Poor, 5 is Great
Presentation and delivery of the online classes
Poor
1
2
3
4
Great
5
1 is Poor, 5 is Great
Speaker's ability to make the classes and information understandable
Poor
1
2
3
4
Great
5
1 is Poor, 5 is Great
Did this program meet your expectations?
Poor
1
2
3
4
Great
5
1 is Poor, 5 is Great
If you answered POOR or FAIR to any of the above please explain:
Please provide any comments on how we can improve the program:
*
Have you done a Detox before? (if yes, how did this one compare)
Why did you decide to do the Detox program?
*
How did you feel before completing the Detox program?
*
What changes did you notice after completing the Detox program
*
What would you say to someone who was thinking about doing our program but had never
*
Your experience is invaluable to others. Do we have your permission to share your story? Please check the option that you approve below.
*
Yes, you're welcome to share my detox experience from this form to your website, social media and use my full name.
Yes, you're welcome to share my detox experience from this form to your website, social media and use ONLY MY FIRST NAME.
Yes, you're welcome to share my detox experience from this form to your website, social media AND NOT SHARE MY REAL NAME.
I prefer that you do not share any of my detox experience
Signature
*
Submit
Submit
Should be Empty: