Influencer Feedback Survey

"*" indicates required fields

Your Name
(1 being lowest and 5 being highest)
(1 being lowest and 5 being highest)
Currently, we ship 4 boxes a year. Is the frequency of the program*
How often would you like to see a box delivered to your home?*
(1 being lowest and 5 being highest)
(1 being lowest and 5 being highest)
(1 being least likey and 5 being most likely)
(1 being least likely and 5 being most likely)
This field is for validation purposes and should be left unchanged.