Green Cleaner Feedback

Hopefully you have had a chance to try out the sample

 We would appreciate knowing what you thought of the biodegradable cleaner we sent to you.

The name and email address are only used to keep track of who received the samples and gave us feedback.  They will not be used to send you more information.  You will continue to receive periodic information about the environment, Green products and ways to clean healthy with your original sample subscription.

If you want to speak to me personally about the cleaner or have other questions, please leave a phone number.

If you would like other information about environmental, physical or financial health, please follow the links or sign up for our monthly newsletter after you have filled out the sample survey.

We Appreciate you Feedback
Please note that all fields followed by an asterisk must be filled in.
First Name*
E-mail Address*
Home Phone
I have used the sample to make a bottle of general cleaner*
If you answered Yes, please rate the cleaner
I have used the sample to make a bottle of window cleaner*
If you answered Yes, please rate the window cleaner
Additional comments on cleaner abilities
If you havent used your sample yet, do you plan to?
Would you recommend this cleaner to a friend?*
Why? (click all that apply)*
How it cleans
Because its "green"
If I told you that you could purchase a bottle of concentrated cleaner that made 48 gallons (384 bottles)of general purpose cleaner, would you buy it if it cost less than $12.

Please enter the word that you see below.


Understand that all collected information can be used by HealthyLife-HealthyPlanet for promotional purposes.  
The information will be kept anonomous.

This way To purchase a bottle of concentrated cleaner that makes up to 48 gallons of all purpose cleaner------->

This way To learn about more "Green" cleaning options-------->

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