IM Questionaire

Questionaire
Before today, had you heard of our products from Immunotec:
Cherry Concentrate? YES NO
Xtra Sharp Energy Tonic? YES NO

lmmunocal/HMS9O or Immunocal Platinum product? YES NO

Are you familiar with ‘glutathione’? YES NO

Is your health an important priority in your life? YES NO

Are you looking for ways to improve your health and energy? YES NO
Are you interested in making health changes? YES NO

On a scale of 1-10, how would you rate your:

NOT WELL FAIR GOOD
Current state of health? 1 2 3 4 5 6 7
8 9 10
Current energy level? 1 2 3 4 5 6 7
8 9 10
Current quality of sleep? 1 2 3 4 5 6 7
8 9 10

Are you looking for a home-based business, or opportunity to earn extra income? YES
NO
Would you be interested in learning how you can “earn” our products free, with
referral? YES NO

Name:______________________________________________________________
Phone Number (with area code):______________________________________

Address (optional):___________________________________________________
*** Email Address (optional):____________________________________________

If you provide your e-mail address, it will only be used to send you
information related to lmmunotec and its products, and
will be given to any third party.

THANK You FOR TAKING THE TIME TO FILL OUT THIS QUESTIONNAIRE!
Draw for FREE bottle of Immunotec Cherry Concentrate or Xtra-Sharp!
Name: ______________________ Phone Number:____________________________

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