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PLEASE GIVE US FEEDBACK about HIRUVAL 35™

Hiruval 35™ has been formulated with your needs in mind. Please give us feedback on your experiences with and use of Hiruval 35™.

Consumers or Practitioners Who Have Used or are Using Hiruval 35™ ONLY, Please.

Please provide the following contact information:
First Name: *Last Name:
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1. Where did you get your Hiruval 35™?

2. Please describe what you used it for. (for example - stains after treatment, dark spots)

3. Did you have treatments for varicose veins or spider veins?
Yes No

4. If you answered Yes to 3., what did you have done? Indicate all that apply.
Vein removal by surgery Injections of your deep veins Spider vein removal Other

5. How soon after the procedures did you start using Hiruval 35™?

6. How many times a day did you apply the cream?

7. How long did you use the cream?

8. Did you achieve a reduction in the skin blemishes?
Yes No

9. How do you rate Hiruval's overall effectiveness?

10. Prior to using Hiruval 35™, have you tried any other remedies?
Yes No

11. What did you try?

12. As compared to other remedies you have tried, please rate Hiruval 35™'s effectiveness.