This questionnaire is a marketing tool. It's purpose is to offer the visitor to your web site a NutriBase Assessment Report (or an email newsletter or other type of report) in exchange for their personal information.

Visitors to your web site would complete this form and click the Submit Button. The information they provided would be stored in a database for you. When convenient, you would download this database and tell the NutriBase to process the file. NutriBase would read the file, add the customer contact data (name, email, etc.) into the Client Contact Manager and use the personal information (name, age, gender, current weight, desired weight, etc.) to log each visitor into the NutriBase software as a new client. NutriBase can process a 100 visitors to this form in about a minute. Once the visitor is logged in as a new client, you can produce a variety of reports for that client.

The goal is to gather contact and personal information from your visitors (contact information and personal information) that you can save for future mailings (newsletters, special offers, etc.).

You can offer a variety of incentives to complete this form. Common incentives include a free monthly newsletter (which you can customize because you know how much the person weighs and has said they would like to weigh), a free NutriBase Assessment Report could be sent within say, 24 hours. Some Clinical SE users charge a small fee up-front for preparing an Assessment Report, then bring the user to this questionnaire after they pay for the service. The visitor's report is emailed back to them via email.

You control the "look and feel" of your questionnaire page. You can change the title, change this copy, add images like your company logo or a photograph of your face, change the form's size, background and foreground colors, change fonts and sizes, add rules and borders to columns and or rows, resequence and/or rename the fields, add additional form entries, modify existing entries, etc., to customize the table to fit into your web site.

When a visitor clicks the Submit Button, our script checks your entries and makes sure that all the required fields are filled in. It also checks to make sure the email address is properly formatted. If something is amiss, a message appears and directs the visitor to the fields that need to be corrected. If everything is okay, this data is copied to a flat-file (text-based) database on our server.

This questionnaire is functional, but we don't normally process these submissions. If you have an interest in seeing a sample Assessment Report, please complete this questionnaire and click the Submit Button. Then email us separately with a request to generate a Nutrition Assessment report and email it back to you. If you do this, we'll download your submission and have NutriBase Clinical SE process it. We'll save your report in a word processor format and email it back to you. :-)