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1
Name
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First Name
Last Name
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2
Post Code
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3
Phone Number
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Please enter a valid phone number.
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4
Email
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example@example.com
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5
What is your highest concern when discussing water quality in your home?
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Unpleasant taste and odor from my tap water
Dry skin and hair after showering or washing
Health concerns such as asthma, eczema, Crohn's disease, or thyroid issues
Limescale buildup and hard water damage
Worries about chemicals like THMs, fluoride, or PFAS in the water
High costs of buying bottled water
Presence of plastics (nano/micro) in water
Safe water for babies and bottle feeding
Desire to support anti-aging efforts
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6
Finding the Perfect Time to Connect
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Early morning (before 9 AM)
Late morning (9 AM - 12 PM)
Early afternoon (12 PM - 3 PM)
Late afternoon (3 PM - 6 PM)
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7
Are you the homeowner or currently Renting the home?
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Yes, I am the homeowner
No, I am renting
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8
Do you currently have a filtered water system within your home?
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Yes, we currently have a filtered water tap in our kitchen.
Yes, we currently have a whole home filtration system.
No, we don't have one yet.
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