EXIT Botox Survey Fill this Botox survey for Best Results Question Title * 1. Have you had Botox injections before? No, I have never had Botox before Yes, I had it less than 6 months ago Yes, I had it more than 6 months ago OK Question Title * 2. If yes, what was the reason to get Botox? Forehead lines Frown lines between the eye brows Smile lines Face slimming Others OK Question Title * 3. If you had Botox before, were you satisfied with the results? Yes No I rather not answering the question OK Question Title * 4. How long have you been looking for a Botox clinic? Less than one month More than one month OK Question Title * 5. Do you get Botox injections for medical purposes such as Migraines? Yes No OK Question Title * 6. Do you have any chronic skin condition or neurological disorder? Yes No OK Question Title * 7. What are your most important criteria in choosing a cosmetic clinic? Google reviews Facebook reviews Number of Instagram followers The clinic location Prices and discounts available OK Question Title * 8. Are you planning to do the injection in the coming two weeks? Yes, I want to do it at Albany Cosmetic and Laser Center and I would like to be contacted to set a free consultation Yes, but I did not make up my mind about the clinic No OK Question Title * 9. How did you hear about us? Google search Facebook ads Instagram ads Word of mouth Printed media OK Question Title * 10. Do you prefer Botox from Allergan of Dysport from Galderma Botox from Allergan Dysport from Galderma No difference, I will go with the clinic suggestion OK Question Title * 11. Please fill in your contact information to receive the 10% discount coupon First name * Last name Email Address * Phone Number * OK Question Title * 12. If you want us to contact you, what do you prefer? Phone call text message email OK DONE