Durban Dames Survey for prospects

Please enable JavaScript in your browser to complete this form.

Do you purchase $100/mo or more in CBD or hemp products? *

• Yes
• No

Which type of CBD/hemp/cannabis products do you utilize? (Select all that apply) *

• Vapes
• Flower
• Pre-rolls
• Gummies
• Oils
• Topicals
• Drinks

Do you utilize CBD, hemp, or cannabis products for (select all that apply): *

• Relaxation
• Sleep
• Anxiety
• PTSD
• Nausea
• Pain relief
• Neuropathy
• Libido
• Other

$100/mo (0=Not POTENCY

How important is PURITY in your decision to purchase CBD/hemp/cannabis products (0=Not important; 5=Most Important)?

Selected Value: 0

How important is POTENCY in your decision to purchase CBD/hemp/cannabis products (0=Not important; 5=Most Important)?

Selected Value: 0

How important is EFFECT in your decision to purchase CBD/hemp/cannabis products (0=Not important; 5=Most Important)?

Selected Value: 0

How important is BRAND in your decision to purchase CBD/hemp/cannabis products (0=Not important; 5=Most Important)?

Selected Value: 0

Would you be interested in getting a 25% off coupon to try Durban Dames products? *

• Yes
• No

Name *

First

Last

Email *

Any special requests or comments?

SubmitSave and Resume Later

Once survey is submitted and reviewed, coupons will be emailed to the address in the survey for 25% off your entire order.

Please note: Durban Dames survey for prospects provides critical information for us to serve new customers based on their specific needs.  The information in this form will be solely used to determine if Durban Dames can service your specific needs.  We do not sell information or share with 3rd-parties.  Surveys are for our eyes only.

Shop our online store for discounts and to utilize coupons.