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Tester Qualification Form

Email used for Early Access signup

First Name

Age Range

City/State

Which best describes you?

Which situation makes you most likely to use this?

Which situation makes you most likely to use this?
A
B
C
D
E
F
G
H
I

How often does this happen?

How often does this happen?
A
B
C
D
E

Where would you keep this product?

Where would you keep this product?

What do you currently do instead?

What do you currently do instead?

What frustrates you most about your current solution?

What frustrates you most about your current solution?

What would make this worth buying?

What would make this worth buying?

Expected price for 10 individually wrapped wipes?

Expected price for 10 individually wrapped wipes?
A
B
C
D
E

Would you test samples and give feedback?

Would you test samples and give feedback?
A
B
C

Are you open to being contacted?

Are you open to being contacted?
A
B

Describe the last time you would have used this product.