1. Name:      E-mail:

2.I engage in hair removal on a: Daily Every couple of days Weekly Monthly

3.How much time, in hours, do you spend each MONTH ridding yourself of unwanted hair?

4.Current methods used to get rid unwanted of hair (check all that apply):
Razor
Electric Shaver
Depilatories (Creams)
Waxing/Sugaring
Tweezing/Plucking
Epilator Device
Professional Laser Hair Removal/Professional Electrolysis

5.Amount of money spent each MONTH for ridding unwanted hair, including all products associated with having to deal with unwanted hair $
(do not add cost of electric devices used in home)

6.Nuisances you hate having to deal with (check all that apply):
Bumps
Ingrown hair
Feel of Stubble
Razor Rash/Redness
Time spent removing hair
Signs of hair despite shaving

7.I consider myself to be physically active. (i.e., play collegiate/intramural sports, regularly go to the gym/run/bike/swim, love the beach, nightlife, attend social events, dating, etc.)
Yes
No
At times

Having to deal with unwanted hair at one time or another has limited my time spent enjoying an active lifestyle
Yes
No

8.I'm familiar with laser hair removal
Yes
Yes, I’ve had laser hair removal; and Am satisfied Was not satisfied with the results
Somewhat
No, I am not familiar with Laser Hair Removal at this time

9.Please answer this question AND #10. My preference for no body hair on WOMEN (or myself as a woman) is:
Underarms
Arms (upper)
Arms (lower)
Legs (upper)
Legs (lower) (including knees)
   Preference for Bikini area:
    Outside Swimsuit Region – hair removed around outer underwear line
    Bikini – Leaving a sculpted “landing strip”, “happy trial” or designing a similar amount of reduced hair
    Brazilian Bikini – Everything is smooth and hair free
   Reason for selection for bikini area: (select all that apply)
    More hygienic feeling
    For sports or reasons of active lifestyle
    Increased sexual sensation with partner
    Don’t want hair beyond underwear line/swimsuit
    Like the aesthetic appearance and feel of smooth skin

9.My preference for no body hair on MEN (or myself as a man) is:
Facial Hair, including one or more of: upper lip, cheeks, jaw line, chin, or neck
Rear Neck Line
Shoulders
Back
Underarms
Arms (upper)
Arms (lower)
Chest area
Abs
Legs (upper)
Legs (lower) (including knees)
Feet/Hands
Buttocks
   Preference for Bikini area:
    Outside Swimsuit Region – hair removed around outer underwear line
    Bikini – Leaving a sculpted “landing strip”, “happy trial” or designing a similar amount of reduced hair
    Brazilian Bikini – Everything is smooth and hair free
   Reason for selection (select all that apply)
    More hygienic feeling
    For sports or reasons of active lifestyle
    Increased sexual sensation with partner
    Don’t want hair beyond underwear line/swimsuit
    Like the aesthetic appearance and feel of smooth skin

Please Add Any General Comments or Insights:

Once submitted you will be given the opportunity to provide an email address for the drawing.

Each quarter, Clearstone Laser Hair Removal & Medical Spa is excited to award $500 worth of complimentary treatments to an individual selected at random by participating in this survey. No cash value. Must receive treatments at any of our Texas locations. Certificate is transferable and is good for one year from date of issuance. To participate, complete and submit survey. Then complete pop-up window with a means to contact you. Odds of winnings depend upon number of completed surveys. The Clearstone Advantage ™ guarantee applies to complimentary treatments..