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Phone *

Discovery Survey

Full Name *

Phone *

When you helped us with our first Research Survey, what was it that interested you most in setting up this meeting? *

You have some health issues you think may be caused from your tap water?

You've been thinking about getting some type of home filtration?

Just wanted to learn more?

Because filters affect our tests, are you using any filters? *

Water Softener/Conditioner?

Any under the sink filters?

Reverse Osmosis?

To confirm, the KITCHEN COLD water is unfiltered? *

Yes

Unsure

Who in the family has the direst / most sensitive skin? *

Is it eczema?

Yes

Do you use medication to treat it?

Yes

Are your ice cubes clear or milky white? *

See Through Clear

Milky White

Have you seen any particles in the bottom of your glass after your ice melts? *

Yes

What do you think those particles are? *

What is your favorite brand of Bottled Water? *

Aquafina

Dasani

Arrowhead

Costco (Kirkland)

The Cheapest

Evian

Smart Water

FIJI

VOSS

Doesn't matter, I never really buy it

On average, how much do you spend a week on bottled water for your household? *

$1 - $3

$4 - $6

$7 - $9

above $10

Other than water, what is your Favorite Drink - spouse 1

Other than water, what is your Favorite Drink - spouse 2

What is your average monthly grocery bill including everything (soaps, meat, dairy, shampoo, paper towels, etc) *

Less than $200

$300 to $400

$400 to $500

$500 to $600

$600 to $700

$700 to $800

$800 to $900

What is your favorite brand of Laundry Soap? *

Tide

Cheer

All

Gain

Costco Kirkland

Arm & Hammer

Molly's Suds

Do you use dryer Sheets? *

Yes

In your dishwasher, do you use a Spot Free Agent like Jet dry or finish? *

Yes

Sometimes

Would you like to receive updates about the water via text?

Yes

P2 Test Results

Record the T.D.S from the kitchen sink tap here

Record the T.D.S from the fridge here

Record the T.D.S from their favorite brand of bottled water here. Include the brand.

Record the Hard Water test here (Tap)

Record the Hard Water test here (Water Softener) - *If no softener put N/A

P2 Wrap Up

Have you ENJOYED GETTING TOGETHER with us and have you LEARNED SOMETHING NEW?

YES: Him

YES: Her

NO: Him

NO: Her

Have we been RESPECTFUL OF YOUR TIME?

YES: Him

YES: Her

NO: Him

NO: Her

Did we keep our word that this meeting was strictly research only?

YES: Him

YES: Her

NO: Him

NO: Her

Do you believe the INFORMATION we've shared is CREDIBLE?

YES: Him

YES: Her

NO: Him

NO: Her

Do you believe there are issues in your water that are affecting you and your family's health?

YES: Him

YES: Her

NO: Him

NO: Her

Would you like to know HOW to protect your family from the issues we have covered?

YES: Him

YES: Her

NO: Him

NO: Her

P2 IR

Full Name *

Phone *

P2 - Who Did It *

Anna
Raegan
Holland
Mel
Trent
Emma
Rhett
Super P3
No elements found. Consider changing the search query.
List is empty.

P2 - Result *

P2 Held - Set P3
P2 Held - Call Back To Schedule P3
P2 Held - Not Interested
No elements found. Consider changing the search query.
List is empty.

P2 Report Card | Toxins

Dibromochloromethane
Trichloroacetic Acid
Haloacetic Acids (HAA9)
Bromodichloromethane
Trihalomethane
Fluoride
Uranium
Chloroform
Lead
Nitrate and Nitrite
Radium
Chromium 6
Arsenic
Chlorite
PFOA
PFOS
Bromate
Mercury
Cyanotoxins
1,4-Dioxane
Manganese
Pesticides
Chlorate
No elements found. Consider changing the search query.
List is empty.

P2 Report Card | Main Concern 1

P2 Report Card | Main Concern 2

P3 - Type *

Zoom
In-House
Mobil
No elements found. Consider changing the search query.
List is empty.

P2 - Charity Water Donation? *

Yes
No
No elements found. Consider changing the search query.
List is empty.

P2 - Report Note *