Online Survey of WCN Skin Lotion After Use

Name:
 E-Mail Address:
Name and Email Address are required fields. These fields must be filled in before submitting form.

  1. Which version of lotion did you use, scented or unscented ?

  2. How long have you used (7 days or 2 weeks )?

  3. How often do you use it a day? 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 times a day on average

  4. Satisfaction of lotion color: Unsatisfied 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 Satisfied

  5. Satisfaction of lotion scent: Unsatisfied 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 Satisfied

  6. Satisfaction of lotion texture: Unsatisfied 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 Satisfied

  7. What do you feel is a reasonable price range for this lotion (1/2 oz)? $10 or less , $10 to $20, $20 to $30

  8. Any positive effects on your skin (e.g., effects on softness, smoothness, moisture, sunburn, sunspot, wrinkles, crack, calluses, acne, eczema, keratosis, melanoma, psoriasis, etc.):


  9. Negative effects on your skin (e.g., redness, sting, itch and other allergies):


  10. Any comments/suggestions: