Mills & Mills Medical Beauty Questionnaire October 2008

Mills & Mills Medical Beauty Questionnaire

If you complete and return this form by the 30th of November you will be entered into a prize draw and you could win £500 worth of M&S vouchers.

Please fill in all the fields below in order to qualify. All information collected during this survey is kept in the strictest confidence.

Name:

First

Last

Age:

Gender:

Email:

Telephone:

Income Level (in GBP or EUR):

Are you happy with the way you look?

	Yes
	No

How important is it to you to look and feel good?

How often do you buy beauty products?

Would you ever consider having Cosmetic Dentistry?

Would you ever consider having Cosmetic Surgery?

Would you consider a free consultation for Cosmetic Surgery?

Would you consider a Free Dental Examination and Assessment?

Go back to www.millsmedical.com
Or contact us here.