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LEVAGIN™ - Feedback Form
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Gender
*
Male
Female
Prefer not to say
Other:
Age
*
Your answer
What kind of stopper does your bottle have?
*
Cork
Screw
How important is convenience when choosing this type of product?
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Not important at all
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Extremely important
What do you like the most about competing products currently available from other companies?
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Your answer
What changes would most improve our product from competing products currently available from other companies?
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Your answer
If you are not likely to use our new product, why not?
*
Do not need a product like this
Do not want a product like this
Satisfied with competing products currently available
Cannot pay for a product like this
Not willing to pay for a product like this
Other:
What would make you more likely to use our new product?
*
Your answer
What did you like the most about LEVAGIN™?
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Your answer
Overall, are you satisfied with your experience using our new product, neither satisfied or dissatisfied with it, or dissatisfied with it?
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Extremely dissatisfied
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10
Extremely satisfied
Would you recommend our new product to others?
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Not likely at all
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Extremely likely
How likely would you consider our product as a gift?
Not likely
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9
10
Extremely likely
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