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* 1. What is your age range?

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* 2. What is your gender?

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* 3. What is your current weight in pounds?

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* 4. What is your height in feet and inches? For example, if you are 5 feet and 4 inches, write 5’4”.

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* 5. Did you consume on an empty stomach as suggested?

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* 6. How many pills did it take to feel the effects?

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* 7. How long did it take after consumption to feel the effects?

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* 8. Did you consume more pills to prolong the experience?

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* 9. If yes, how many additional pills did you consume?

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* 10. How long after the first set of pills did you consume the secondary set?

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* 11. How long did the secondary consumption last versus the first?

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* 12. Did it create the same quality of experience?

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* 13. Did you continue onto a third set or more?

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* 14. If so, please elaborate on the experience.

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* 15. Do you prefer morning, afternoon or night for consumption of Blissgevity or all of the above, why?

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* 16. We are contemplating a second product with the same ingredients and the same effects.  It would constitute a powdered drink to mix a stick pack or pouch that has a pleasant taste when stirred with water. It would be combined with pills but the consumer would only need to take half or 1/3 the amount of pills to be effective.  Would you prefer this product if it was comparably priced?  Or would you just prefer the simplicity of just taking pills alone even if it meant twice as many pills as the drink pill combo?

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* 17. In your own words, tell us about your experience with Blissgevity:

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* 18. Thank you for taking the time to provide your feedback. Please provide your email address if you would like to receive future updates from Blissgevity including discount codes and promotions. 

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