Himani BOROPLUS

Fill out the following form to Submit your FEEDBACK on Boroplus Product Range

Please use proper spacing and avoid using any abbreviations in the address field.

1. Name:

Age:

2. Sex:

Male

Female

3. Address:

4. State:

Zip:

Country:

5. Phone:

Email:

6. What is your occupation?

any other

7. Do you use a Medicated Skin Care Cream?

Yes

8. For what purpose do you use a Medicated Skin Care cream?

Everyday Skin care

Sun Protection

Minor Cuts

Minor Burns

Fungal skin infection

Chapped skin

Chill blains

Winter dryness

After shave

Vitiliago

any other

9. Do you think a Medicated Skin Care Cream can be used for daily protection?

Yes

10. What are the attributes of an ideal Medicated Skin Care Cream?

Heals

Antiseptic

Treatment

Protects

11. What helps you to decide which skin care product to buy?

	Solution to a specific problem		Advertisement		Right Price
	Recommendation from retailer		Recommendation from friend		Attractive Packaging

12. Have you heard about Boroplus Skin Care Cream?

Yes

13. Which statement best describes your usages pattern of Boroplus?

14. What quantity of Boroplus Cream you use at a time?

any other

15. How long did you use Boroplus?

any other

16. How did you come to know about Boroplus?

any other

17. Where do you normally buy your Boroplus from?

any other

18. For what purpose do you normally use Boroplus?

Everyday Skin care

Sun Protection

Minor Cuts

Minor Burns

Fungal skin infection

Chapped skin

Chill blains

Winter dryness

After shave

Vitiliago

any other

19. What do you like/dislike about the Boroplus Antiseptic Cream?

Fragrance :	Colour :	Thickness :
Put your perception about Boroplus :

20. Have you heard of other Boroplus Products? Have you used any of them?

	Heard of	Used	Not Used
Boroplus Herbal Cream
Boroplus Lotion
Boroplus Soap
Boroplus Anti fungal Cream
Hand & Nail Cream
Foot Cream
Hand wash
Sanitizer
Acne Cream
Pimple Cream

21. What other Products do you think would be useful with similar properties like Boroplus?

Please specify :

22. According to you Pricing of Boroplus is-

or Should be between

and

Helping you with your everyday needs is important to us. Therefore, from time to time, we may wish to send you information, samples or special offers that we feel may be of interest to you regarding BOROPLUS, If you would rather not opt in to receive additional information and offers, please uncheck the box below.

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