PainBreak  
 
"PainBreak Will Give You Relief That Will Absolutely Amaze You."
"Guaranteed! Or Your Money Back!"
 
     

 

 

 

 

SURVEY

Thank you for visiting the Pain Relief Center and reading the introductory description.

If you will take a few seconds to answer the following questions for me, I will reward you handsomely for your time.

What will I do? I will immediately send you a FREE copy of my booklet "7 Easy Steps to Coping With Post Herpetic Neuralgia Pain."

What will I do? I will immediately send you a FREE copy of my E-Book "Shingles & PHN Reports"

You are welcome to request any or all of the following FREE reports:

10 Easy Steps to Managing Shingles

"Discover the 19 Ingredients That Make PainBreak so Effective"

If you have previously completed this survey, kindly do not complete it again, as you already have ALL the available materials.

Please answer the following questions and then press the submit button at the bottom. (Please be honest. I am looking for honest feedback):

Are you interested in learning about new products that could improve the quality of your life or that of a loved one?

Yes No

Are you looking for pain relief for:-

Yourself
Family Member
Friend

What is keeping you from trying PainBreak right now?

Need More Information
Need to Know the Ingredients
Skeptical

If you did not finish reading the information on PainBreak what kept you from finishing it?

Would you be interested in learning about other forms of treatment for post herpetic neuralgia?

Larrea a natural antiviral treatment
Magnetic Therapy

Thanks for your help. To receive your FREE booklet, please list your name and address below.

First Name:
Last Name:
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E-mail Address:

Thank you for completeting this survey.
You will receive your FREE E-Book
"Questions You have… Answers You Need!"

I value your privacy, and will never share your e-mail address.

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