Zen VYBEZ Wellness – Sample Feedback Form
Thank you for trying our Muscle + Nerve Relief Balm sample!Your feedback helps us improve and create the most effective products possible.This form takes less than 2 minutes to complete.
1) Name
2) Email
example@example.com
3) Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
4) Which sample size did you try?
*
1 oz – 100mg CBD : 100mg THC
1 oz – 300mg CBD : 300mg THC
Other
5) If "Other", please specify
6) How did you use the balm?
*
Muscle aches/soreness
Joint pain
Back pain
Nerve pain (sciatica, neuropathy, etc.)
Post‑workout recovery
Hands/wrists (repetitive strain)
Head/temples (tension)
Other (please specify)
7) If "Other", please specify
8) How quickly did you notice relief?
*
Within 5 minutes
5–15 minutes
15–30 minutes
30+ minutes
No noticeable relief
9) How effective was the balm for your needs?
*
1
2
3
4
5
10) How long did the relief last?
*
Less than 1 hour
1–2 hours
2–4 hours
4+ hours
11) Please share your experience in your own words.
Hint: What did you apply it to? How much? How often?
12) How did you like the scent?
1
2
3
4
5
13) How did you like the texture/absorption?
1
2
3
4
5
14) Would you purchase this balm in the future?
*
Yes
Maybe
No
15) Any suggestions for improvement?
16) Would you like to be added to our products mailing list?
Yes
No
17) Do we have permission to use your testimonial on our website or marketing materials?
*
Yes, you may use my feedback with my first name only
Yes, but anonymously
No, please keep my feedback private
19) Date Used (approximate if specific date is unknown)
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Month
-
Day
Year
Date
Submit
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