Weight Loss and Diet Motivator

Weight Loss Motivator

Your feedback is important to us!

Thank you for taking the time to share your thoughts with us.

How many times have you visited our web site before?
This is my first visit Visited Two-Three times before

How would you rate the overall quality of our web site?

Ease of Use
Very Poor Poor Good Very Good Excellent

Colors
Very Poor Poor Good Very Good Excellent

Web site answered all your questions
Very Poor Poor Good Very Good Excellent

Do you have any questions not answered?

Do you feel that our product will be able to help you lose weight?
Yes No Not Sure

Will you be ordering the Weight Loss Motivator Software?
Yes No Not Sure

If not, Why?

Where did you hear about our web site?

Search Engine -	Keyword Used:
Other web site -	Address:
Classified Ad -	Where:
Newspaper Ad -	Where:
Mail Ad -	Where:
Friend or Relative-	Did they order our package: Yes No

What were you hoping to find at this web site that you did not find?

What other comments or suggestions do you have for us?

Your e-mail address:

Your Name:

Your Phone: