Test Trial Application

Thank you for taking interest in our upcoming test trial!

Our goal through this application is to collect a diverse grouping of testers that vary in age, experience with probiotic products, and reasons for seeking out a supplement.

The personal information we collect from this form will only be used to contact you regarding your eligibility for the trial or to provide you with upcoming product info and offers.

We honor your trust and respect your privacy; therefore, we will never sell or share your information with any third-party entity. See our FAQ for our privacy policy.

If you have any questions or change your mind about your application, feel free to contact us at support@elechocolates.com

Full Name

Phone

Please provide your age and gender.

What experience do you have with probiotics?

ie. No experience. Tried them once for a certain number of days? Currently take supplements in a capsule or powder form? Consume live cultures naturally through foods like yogurt and sauerkraut?

Have you experienced any health improvements with other probiotics?

ie. Decrease in food allergy symptoms? Better sleep? Overall better digestion?

How often do you exercise?

Regularly
Occasionally
Never

How healthy / balanced is your diet?

Healthy
Moderately healthy
Not too healthy

How would you rate your overall health?

Good
Moderate
Less than moderate

What about our probiotic sounds the most appealing to you? Are you looking for a new daily supplement?

I voluntarily agree to provide information to Ele Chocolates as part of this survey. I understand the information in this survey may be used for marketing purposes, in ways that will not reveal who I am.

I agree

Thank you for your application!

We appreciate you taking interest in us. If selected, one of our colleagues will get back in touch with you in soon!

Have a great day!

Thank you for your application!

We appreciate you taking interest in us. If selected, one of our colleagues will get back in touch with you in soon!

Have a great day!

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