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Questions marked with an * are required Exit Survey
 
 
* Do you take your health seriously?
   
 
 
 
* What type of water do you currently drink?
 
Tap - Unfiltered
 
Tap - Filtered
 
Reverse Osmosis
 
Filtered
 
 
 
* Are you or someone you care about suffering from any health challenges?
   
 
 
 
* How much money do you spend per day on: Water, Coffee, and or Energy Drinks?
   
 
 
 
* What did you like best about the Kangen water demo?
   
 
 
 
* If you were to buy a Kangen system, why would you buy one?
   
 
 
 
* If you bought one and loved it, would you want to recommend it to others? Yes No
   
 
 
 
* Your Email and Phone number. Time of Day that we can contact you.
   
 
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