Thursday February 9, 2012 2:04 pm
Submit a Success Story
Our clients share their successes in their treatment What is a success story? It's a brief write-up of your successes with treatment, a realization regarding something you now understand about taking care of your body, etc.

Why do it? Simple! it validates (to make right or correct) your success in handling a problem you had. It allows you to accomplish more of the same. Want to see examples? Go here. When you are finished just close the new window and you will be returned to this page.

Answer the following questions. Items with * are required for processing.


Your Information
  * First Name:
  * Last Name:
  * Email:
  Customer Username:


Treatment Inception
 

When did you first start treatment? (Approximate if you're not sure)

 

* Treatment Start Date:

 


What Help Were You Seeking?
 

* What health problem(s) did you want handled at that time?

 


How Long Did You Have This Problem?
 

* Select on long you'd had the health problem(s):

 

 

Additional Comments:

 


What Effect Did Your Health Problem Have On You and Your Life?
 

* How were these problems affecting your life?

 


Your Success
 

* What successes would you like to share?

 


Telling Others
 

* What would you tell others about our service and expertise in dealing with you and your health?

 


Would Others Benefit?
 

* Would you want others to have similar wins?

 

No
Yes


Other Comments
 

Anything else you'd like to add?

 


Permission to Publish
 

* Thank you for your success story and very well done! Would you give us permission to use your success story in promotional offers? If you do so and provide a picture of yourself we'll give you $10 off your next supplement order. Your name or information will never be sold to any outside agency.

 

No
Yes


Free Health Newsletter
 

Haven't subscribed to our free newsletter? If not do so. We do NOT sell or release the names of our clients to any outside party.

 

Healthy Newsletter - Each week the Healthy newsletter brings the latest research, news and ideas you can use, fun mini-quizzes and a listing of the live events and happenings on the BecomeHealthyNow sites and communities.

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