Do you understand the true causes of cellulite and loose under arm skin?
 Fully A little bit Not at all

Would you like a detailed medical description of the causes?
 Not really Possibly Definitely

Are you interested in long term solution to the problem or just a quick fix?
 Just short term Not sure Long term

Many women blame Cellulite and loose under arm skin for their choice of clothing. Do these problems effect what you wear?
 Not at all Sometimes Always

Does your Cellulite or loose under arm skin prevent you from engaging in any sporting or fitness activities?
 Not really Maybe sub-consciously Yes

Would you be more confident if your skin regained elasticity and was much smoother?
 No Not sure Definitely

Many women blame Cellulite or loose under arm skin for their choice of beach wear . Do these problems effect what you wear on the beach?
 Not at all Sometimes Always

Do you feel comfortable in a Bikini on the Beach?
 Yes Only if there are very few people around Not really

Does your problem sub-consciously reduce the number of Beach Days or Outdoor days you spend with friends and family?
 Not at all Not sure definately

Does your problem have any effect on your self esteem?
 Not at all Sometimes Always

Would you feel more confident in yourself if you were happier with your physical appearance?
 Not really Not sure Definately

Do you think your relationship would improve if you reduced your Cellulite and had more self-confidence?
 Not at all Not sure Definately

Your Name

Your Email

Phone

Your Post Code