Customer Questionnaire

Complete the simple form below and receive a 15% discount.

In order to help us monitor how M-Folia is helping people, it is important to obtain feedback. For this reason, we have re-introduced the Questionnaire (below).

Please complete the form & as a Thank You, we will send you a discount code reducing your next order by 15%*

*IMPORTANT: Please note that the coupon code is valid for this month only.
However, a new coupon code may be obtained next month by re-completing the questionnaire.

The discount code will be emailed to you. Please make sure that emails from taylor-jackson.com are authorized by your email client or check your spam folder.

Your Name (required):

If you completing this questionnaire on behalf of someone else, please state their name:

Skin condition M-Folia has been used for:

Gender of User (required):

Which M-Folia products have been used? (required) Use Control+Shift to select multiple products:

How long have you been using M-Folia for:

What are the results so far?(required):

If you have been using other products, please insert here:

How much are you affected by Stress?

How much alcohol do you drink?

Do you eat red meat?

Do you smoke cigarettes?

Additional Comments (including any other products or services you would like us to supply):

Your Email (required):

 

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