Preferred Customer Packaging Survey – 2015

We are conducting a survey and looking for some quick feedback on three new packaging looks.Complete this short survey to receive a 35% Off coupon code for our online store. Coupon code valid until Dec. 24th, 2015. Coupon code will be emailed to you once we have received your responses.

 

[contact-form to=’survey35@integrityhealth.tv’ subject=’Preferred Customer Survey Response ‘][contact-field label=’Name’ type=’name’ required=’1’/][contact-field label=’Email’ type=’email’ required=’1’/][contact-field label=’Age’ type=’select’ required=’1′ options=’18-25,26-35,36-45,46-55,55+’/][contact-field label=’Gender’ type=’radio’ required=’1′ options=’Female, Male’/]

Choice 1 – Please select one of the following:

Package A
Package B
Package C

 

 

 

 

 

 

 

 

 

 

 

[contact-field label=’Choice 1 – Select the package design you prefer:’ type=’radio’ required=’1′ options=’Package A,Package B,Package C’/]

[contact-field label=’Choice 1 –  Why did you select this package design?’ type=’textarea’ required=’1’/]

Choice 2 – Please select one of the following:

Package A
Package B
Package C
Package C

 

 

 

 

 

 

 

 

 

 

 

[contact-field label=’Choice 2 – Select the package design you prefer:’ type=’radio’ required=’1′ options=’Package A,Package B,Package C’/][contact-field label=’Choice 2 –  Why did you select this package design?’ type=’textarea’ required=’1’/]

 

Choice 3 – Please select one of the following:

Package A
Package B
Package C

 

 

 

 

 

 

 

 

 

 

 

[contact-field label=’Choice 3 – Select the package design you prefer:’ type=’radio’ required=’1′ options=’Package A,Package B,Package C’/][contact-field label=’Choice 3 –  Why did you select this package design?’ type=’textarea’ required=’1’/]

 

 

[/contact-form]