Chemistrie Clip Survey Question Title * 1. Name Question Title * 2. Email Question Title * 3. When did you purchase your Chemistrie Layer? Question Title * 4. Where did you purchase your Chemistrie Layer (Name, City, and State please): Question Title * 5. What Chemistrie Style did you purchase? Chemistrie Sun Chemistrie Plus Chemistrie Blue Chemistrie 3D Other (please specify) Question Title * 6. I heard about Chemistrie from: My Eye Doctor My Optician Family or Friend The internet Other (please specify) Question Title * 7. With my purchase I received a complimentary Chemistrie Case Chemistrie Cleaning Cloth Other (please specify) Question Title * 8. How satisfied are you with your Chemistrie Layer? Very Happy Satisfied Unhappy I am: I am: Very Happy I am: I am: Satisfied I am: I am: Unhappy Question Title * 9. Any other thoughts, comments, or questions are greatly appreciated! Done