EvoCann Product Survey
Exit Survey
Questions marked with a
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are required
100%
What is your date of birth?
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
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Year
1900
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2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
What conditions do you currently have?
Hypertension
Hyperlipidemia
Diabetes
Back pain
Anxiety
Obesity
Allergic rhinitis
Reflux esophagitis
Respiratory problems
Hypothyroidism
Visual refractive errors
General medical exam
Osteoarthritis
Fibromyalgia / myositis
Lupus
Malaise and fatigue
Pain in joint
Acute laryngopharyngitis
Acute maxillary sinusitis
Major depressive disorder
Acute bronchitis
Asthma
Depressive disorder/PTSD
Candida
Coronary atherosclerosis
COPD
Krone's Disease
Urinary tract infection
Autism
Parkinson's Disease
Alzheimer's Disease
Cancer
Dermatitis
Eczema
Psoriasis
IBS
Seizures
Dementia
Epilepsy
Liver Disease
Rheumatoid Arthritis
Migraine
Menopause
Which Products have you tried?
Full Spectrum Balm
Massage Cream
Infused Tea Paste
Full Spectrum Capsules
Full Spectrum Lotion
Full Spectrum Bath Salt & Bomb
Full Spectrum Face Serum
Full Spectrum Deodorant
Full Spectrum Toothpaste
Full Spectrum Charcoal Face Scrub
Full Spectrum Lip Balm & Oil
Full Spectrum Hair & Scalp Oil
Full Spectrum Hair & Beard Balm
Full Spectrum Mouth & Breathe Spray
Full Spectrum Edibles
How would you rate your overall experience?
Product Experience
1
2
3
4
5
Product Result
1
2
3
4
5
Customer Experience
1
2
3
4
5
Product Value
1
2
3
4
5
Please Comment/Suggestions:
Contact Information
First Name
Last Name
Phone
Email Address
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