Name:

Email Address:

Location:

How did you hear about us?

How often do you use Eye Magic?

Daily
Once a week or more
2-3 times a month
Less than 3 times a year

Overall, how satisfied are you with Eye Magic?

Extremely satisfied
Very satisfied
Somewhat satisfied
Unsatisfied
Very unsatisfied

Would you purchase Eye Magic again?

Definitely
Probably
Maybe
Probably not
Definitely not
Never used Eye Magic

Would you recommend Eye Magic to others?

Definitely
Probably
Maybe
Probably not
Definitely not
Never used Eye Magic

Which Eye Magic strip shape do you find most useful?

Eye Magic I (for almond-shaped eyes)
Eye Magic II (for round-shaped eyes)
I do not find either to be useful

What recommendations would you offer for improving Eye Magic? (optional)

Enter your testimonial to be published on our web site (optional)
By entering a testimonial, you are giving permission to publish your testimonial on our web site

Which of the following may we use if your testimonial is published?

You may use my first name, last initial and location
Please keep my testimonial anonymous
I am not submitting a testimonial