'Eczema/Dermatitis and Nutritional Deficiencies' Questionnaire

This competition has now closed but you can still do the survey for your own information or join our newsletter as we will be sending a PDF 'Nutrient Deficiency Questionnaire' for our members to keep. You can join our newsletter here: http://eepurl.com/bF2HtL (It's a Mailchimp link) or via our website at the bottom of the page http://www.eczemalife.com/

Take part in this informative survey and be in the running to win one of 15 Test My pH kits. Entrants need to be adults or parents of children with eczema, age 2 or older. Entries close on May 11th 2016.

This questionnaire can also give you insights into your own health so please take the time to give accurate answers. Your information is confidential and it will helps us to determine the top 5 nutrient deficiencies that people with eczema and dermatitis have. The more entries we have, the better we can help others who are suffering. It should only take 5-7 minutes to fill out. Thanks!

*Please note, the vitamins and minerals that are in Skin Friend are denoted with an asterisk so if a range of deficiencies show up you won't need to buy these nutrients separately.
If you have any questions while filling out the survey email support@jolieeskin.com 

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* Your Information

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* How did you hear about this survey? Pick one option only:

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* If you ordered Skin Friend, enter your order number e.g. #1122 (this is the number sent to you via email when you placed your order at jolieeskin.com or eczemalife.com)

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* Age range
Please specify your age range

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* Do you have any of the following skin conditions?

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* Gender

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