Customer Information
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First Name * | |
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Last Name * | |
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Company Name | |
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E-mail * | |
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Phone Number | |
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Address * | |
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Apt/Suite/Floor | |
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City * | |
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ZIP * | |
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Country * | |
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State * | |
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Where did you purchase this Tanita Product? | |
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Where did you hear about us? | |
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Did you receive this Tanita product as a gift? | |
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Will you primarily use this Tanita product to monitor your | |
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How many people in your household will regularly use the body fat monitoring function? | |
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How satisfied are you with each the following Tanita product attributes? | |
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Product design | |
Overall satisfaction | |
Weight capacity | |
Features | |
Ease of use | |
Accuracy | |
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How likely are you to recommend Tanita to your family and friends? | |
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| Internet survey |
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Telephone survey |
Mail survey |
Testimonials |
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| Tanita body fat / body composition monitors |
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Tanita kitchen scales |
Tanita hand-held healthcare products |
Other, specify |
Any additional comments or remarks? | |
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About You
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Your gender | |
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Your age | |
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Your highest level of education | |
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Your annual household income | |
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Approximate number of hours you exercise in a typical week | |
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(Check all that apply.) | |
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Swimming |
Weight Lifting |
Others (baseball, basketball, etc. |
Marathons |
Running |
Walking |
Aerobics |
Triathlons |
Bicycling |
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Yes, I'd like to receive periodic information on fitness and health measurement to help me lead a healthier life, as well special offers on healthy lifestyle products from Tanita. |
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