Lice Off All-Natural, Non-Toxic Head Lice Treatment: Testimonial Submission Form

Lice Off™ Testimonial Submission

Rainforest Essentials guarantees your privacy. Your full name and address will not be used in any marketing or promotions, and will not be released to any third party (see our Privacy Policy below) without your express permission.

Please fill out as completely as possible

First Name: Last Name:

Company Name

Street Address

City State Zip Code

Province (Outside USA)

Country

Home Phone Business Phone Fax

E-Mail Address

How did you first hear about Lice Off?

Which product or package did you purchase?

In selecting "Yes" below, I hereby give permission to Ecopax Distributing to use my testimonal for any and all marketing and research purposes:

Comments & Questions:

Privacy Policy: We ask for several pieces of personal information, including a phone number and email address where you can be reached for follow-up. We cannot send out information without this to complete our records, but your personal information will not be sold, shared or otherwise divulged by any method to any other party outside of employees of Rainforest Essentials

This means your personal identity will never become part of any other company's marketing efforts, and you will never be contacted by another customer or third party for any reason. We may, however, contact you when new specials or programs promoting our line of products are available. We may also contact you in conjunction with any orders you have placed with us if the need arises. If you have any questions or suggestions regarding this policy, please contact us.