CoolQueen Product Trial Application & Pre-Trial Survey

Name*

First NameLast Name

Email*

example@example.com

Why are you interested in participating in this product trial?*

Are you willing to take the product consistently as directed and complete the follow-up survey at the end of the trial?*

YesNo

Please provide the address to where we can send the product.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Would you like to receive daily motivational text messages during the 30-day product trial? Our CoolQueen Consistency Coach sends quick reminders, encouragement, and perimenopause wisdom to help you stay consistent and get the best results.

Yes, I’d love daily texts!No thanks, I’ll track on my own.

If you said Yes above, please provide your phone number!

Please enter a valid phone number.Format: (000) 000-0000.

Section 2: Pre-Trial Survey

This short survey will help us understand your symptoms before starting the product so we can track how things change over the next 30 days. Be honest, be real — there are no wrong answers.

Disclaimer & Consent

By participating in this survey, you acknowledge that the information you provide will be used to help us evaluate the effectiveness of our product. Your responses may be aggregated (combined with others) and shared anonymously for research and marketing purposes, such as on our website or in promotional materials.

If you choose to share a testimonial or detailed response, we may request your explicit permission to quote you directly. You are under no obligation to do so.

If you opt in to receive daily text messages from our CoolQueen Consistency Coach, you consent to receiving motivational and educational messages related to the CoolQueen product trial, as well as occasional updates and offers from Bad B Botanicals after the trial. Message frequency may vary. Standard message and data rates may apply. You may unsubscribe at any time by replying “STOP.”

Your data and contact information will never be sold or shared with third parties outside of our company.

Are you currently experiencing perimenopausal symptoms?*

YesNoNot sure

Do you experience hot flashes?*

YesNo

If yes, how often?*

DailyA few times a weekWeeklyRarely

On average, how many hot flashes do you get per day?*

How intense are your hot flashes on average? (1 = very mild, 5 = very intense)*

Night Sweats*

Irritability or mood swings*

Brain fog*

Anxiety or feeling “on edge”*

List any other symptoms you experience here:*

What would a “successful result” look like to you after 30 days of taking this product?*

CoolQueen Product Trial Application & Pre-Trial Survey

Section 1: Application

Part 1: Basic Info

Part 2: Related Symptoms

Part 3: Expectations