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1. Are you concerned about the environmental effects on your skin? * YesNo

2. Do you use any of the following on a regular basis? * Hair CareBody Cream/LotionFragrancesSkin CareBath Products

Choose one or more

5. If we could help you with products concerned with all these issues, would you be interested? * YesNo

3. Are you interested in your appearance? * YesNo

4. If you were to purchase personal care products, what would be your main concerns? * PriceHypoallergenicNatural IngredientsEnvironmentally friendlyLates technologySunscreensAllergy testedMoney-back guaranteeSimplicity

5. If we could help you with products concerned with all these issues, would you be interested? * YesNo

6. Would you prefer information on safe and effective products being sent to you? * YesNo

Name *

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Address

Telephone(Work)

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Is there anyone else you know who could benefit from this survey?

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