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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About Product
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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
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Overall satisfaction
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Weight capacity
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Features
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Ease of use
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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
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| Mail survey
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| Testimonials
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| Tanita body fat / body composition monitors
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| Tanita kitchen scales
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| Tanita hand-held healthcare products
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| Other, specify
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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.) | Swimming
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| Weight Lifting
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| Others (baseball, basketball, etc.
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| Marathons
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| Running
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| Walking
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| Aerobics
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| Triathlons
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| 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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