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If you are 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):

Would you recommend M-Folia to your friends & family?:

How much are you affected by Stress?

How much alcohol do you drink?

Do you eat red meat?

Do you smoke cigarettes?

What other products have you tried in the past?:

Would you be happy for us to contact you to discuss your experience?

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

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