Potential Customer Survey... May I help you with any health and/or lifestyle needs? Let's Begin with a few questions...

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I am an Independent Business Owner with Amway, and I'm super excited to help provide essential lifestyle solutions for everyday needs. Based on your answers below, I can create a customized profile for you and start connecting you to wonderful brands you and your family will love!

Email *

Name (First and Last)

Age Group (Select one category from the drop down)

Do you have health and/or wellness concerns in any of the below areas? Select all that apply.

Stress

Weight Management

Joint Pain

Vision/Eye Health (i.e. blurry vision, dry eye, cataracts, etc.)

Gut Health

Sleep

Liver Health

Cholesterol

Energy and/or Focus

Brain Health (i.e. Memory, preventive care, etc.)

Women's Wellness (i.e. Menopause, PMS, etc.)

Immunity

Other (please explain below)

Other areas of health & wellness concern:

Are you open to trying new vitamin and/or supplement options?

Yes

Clear selection

If you exercise, do you have any concerns with your workouts? Select all that apply.

Energy and/or focus (before and/or during workout)

Post-Workout Recovery

Optimizing Hydration

I do not have any workout concerns

N/A, I do not workout

Other:

Do you prefer to eat, drink, or take a tablet to help with a need?

I prefer to EAT products to help with a health need

I prefer to DRINK products to help with a health need

I prefer to TAKE A TABLET (OR GUMMY) to help with a health need

Do you have children (ages 4-12)? If so, are you interested in learning about children's vitamins?

Yes, and I would like more information about children's vitamins.

Yes, but I am not interested in this information.

I do not have children in this age group.

Clear selection

When you go to a store (online or in person) what determines if you buy a product or not? Select all that apply.

Quality

Convenience

Naturally Sourced (Eco-friendly, natural ingredients, all-natural, "green", etc.)

Price

Meeting an Essential Need

Are you open to exploring and learning more about naturally-sourced, high quality brands to potentially switch to from brands you are more familiar with and/or currently use?

Yes

If so, in which product category are you willing to try new brands? (Select all that apply.)

Vitamins and Supplements

Natural Energy Drinks

Weight Loss Management

Makeup

Skincare

Body Care (i.e. Lotion, Body Wash, etc.)

Wellness and Exercise Essentials (i.e. Pre- and Post-Workout Products, Protein Shakes, etc.)

Topical CBD Products

Wholesome Snacks

Home Essentials (i.e. Laundry Detergent, Dish Soaps, Home Cleaners, etc.)

Do you have special dietary or consumption requirements?

Vegan

Vegetarian

Gluten Free

Dairy Free

No Restrictions

Other:

May I contact you by email or phone with any health and/or wellness products that I have that may assist you, based on your survey responses?

Yes (I prefer a phone call)

Yes (I prefer an email)

No, thank you!

If you wish to be contacted by phone, please include your phone number.

Submit

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