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Dose Experience Form
Please fill this out so I can get you a two day taste of our incredible DOSE product set. I am confident you will have an amazing experience and see the value of using these products in your life every day.

You are required to complete all fields to submit your form

NB: You are required to complete all fields to submit your form

To help me get to know you better, please tell me which of the following benefits would improve the quality of your life the most?
Which sample set would you like to try? ALL SAMPLES will include the Elevate Max+ Capsules to complete the DOSE experience
Will you commit to letting me know when your samples arrive in the mail and give me your honest feedback after the two days? 
Hi I'm         
Jeremy Jackson
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