Progress Follow-Up Form
Provides progress feedback since initial use of Cellulite-Ltd III

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To assist you in improving the appearance and condition of your cellulite, please complete "all blanks" below. Optional information (up to a full page of your comments) is welcome in the comment section. If you click on the SEND button and are told that your "Progress Follow Up" is not complete, press the BACK button on your browser and check for any incomplete form fields.

Thank you for your feedback!!!

Name:  

File date or order 'date' on personalized letter to you:  
Email address:   
1. What areas of the body have cellulite?
2. What medication have you most recently used "prior" to using Cellulite-Ltd III?
3. On a scale of 1 to 10 please rate the appearance of existing affected skin area after the use of Cellulite-Ltd III:
No noticeable change
over prior product		 Significant improvement
over prior product
0  1  2  3  4  5  6  7  8  9  10 
4. Other thoughts or comments in reference to the use of Cellulite-Ltd III to make
  • It more efficient,
  • The web site more efficient,
  • or any personal items that you have found in food, lifestyle, or environment that could be helpful to others?
  • or any other comments used in conjunction with 1 through 3 above that could further identify any problem areas, or any other problems resolved.


Please include your answers to the following so we may assist you further.
  1. Are you consistent in applying the Cellulite-Ltd III daily? Yes     No

  2. Do you have an exercise routine which you follow in your extra time? Yes     No

  3. Have you adjusted your diet to help improve your cellulite? Yes     No

   



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  Cellulite-Ltd III has a 120 day, 100 percent refund for any reason.