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| First Name * |
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| Last Name * |
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| Company Name |
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| E-mail * |
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| Phone Number |
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| Address * |
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| Apt/Suite/Floor |
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| City * |
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| ZIP * |
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| Country * |
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| State * |
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Where did you purchase this Tanita Product? |
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Where did you hear about us? |
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Did you receive this Tanita product as a gift? |
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Will you primarily use this Tanita product to monitor your |
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How many people in your household will regularly use the body fat monitoring function? |
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How satisfied are you with each the following Tanita product attributes? |
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| Product design |
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| Overall satisfaction |
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| Weight capacity |
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| Features |
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| Ease of use |
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| Accuracy |
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How likely are you to recommend Tanita to your family and friends? |
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Internet survey |
| Telephone survey |
| Mail survey |
| Testimonials |
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Tanita body fat / body composition monitors |
| Tanita kitchen scales |
| Tanita hand-held healthcare products |
| Other, specify |
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Any additional comments or remarks? |
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| Your gender |
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| Your age |
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| Your highest level of education |
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| Your annual household income |
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| Approximate number of hours you exercise in a typical week |
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(Check all that apply.) |
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| Swimming |
| Weight Lifting |
| Others (baseball, basketball, etc. |
| Marathons |
| Running |
| Walking |
| Aerobics |
| Triathlons |
| Bicycling |
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| Yes, I'd like to receive periodic information on fitness and health measurement to help me lead a healthier life, as well special offers on healthy lifestyle products from Tanita. |
Note: Communication will be sent to the e-mail address you provided. Your privacy will be fully respected. For your convenience, all future contacts will include a link to remove yourself from the program at any time. |
Thank you very much! Note that the "Tanita Product Limited Warranty" requires proof of purchase for all warranty claims. |
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