Take the Health Survey and register to win a YEAR supply of PEAK ADVANTAGE

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On-Line Health Survey

Register to win a year supply of Dr. Hansen’s High Potency Multi-vitamin and Mineral formula, Peak Advantage (12 bottles) a $550.00 value! To enter, simply fill out the entry form below.

Yes please enter me in the sweepstakes and let me know if I have won the year supply of Peak Advantage!
1.How often do you take a multi-vitamin? Daily Occasionally Never	2. Do you take herbal supplements? Yes No
3. Where do you usually shop for Nutritional Supplements? On The Web Health Food Stores Grocery Stores Drug Stores Doctors Office	4. Where do you get the information that you use to decide what supplements to take? (check all that apply) Books Magazines Newsletters Internet Naturopathic Physicians Chiroprators Medical Doctors
5. Do you get an annual wellness exam to help prevent heart disease, cancer, stroke, diabetes, etc. Yes No	6. Does your daily multivitamin contain enough Vitamin E (400 I.U.) to reduce your risk of heart disease by 75%? Yes No
7.Does your daily multivitamin contain enough Folic Acid to prevent colon cancer (< 400mcg per day taken on a consistent basis)? Yes No	8. Studies show that daily consumption of as little as 400mg of Vitamin C daily can reduce your risk of dying from any cause by 42%. Do you get enough Vitamin C daily? Yes No
9. What are the three most important factors in making your decision to purchase a product? Clinically Tested Ingredients Patented Ingredients Price Quality of Ingredients Standardized Ingredients Trademarked Ingredients	10. Does your Multi-Vitamin contain enough Selenium (200mcg), as selenomethionine, to reduce your risk of Breast Cancer your Prostate Cancer? Yes No
	11. How many servings of fruits and vegetables do you eat daily? None 1-2 3-4 5+
About You:
What is your age? Under 20 20-29 30-39 40-49 50-59 60-69 70-79 80+	How would you describe your weight? (Optional) Underweight (more than 20 lbs underweight) Average Overweight (10-30 lbs overweight) Obese (more than 30 lbs overweight)
Name: Address: City: St: Zip: E-Mail:
Do you already subscribe to our E-newsletter, Your Vital Health News? Yes No

All questions must be completely filled out for valid entry. No purchase is necessary. All entries must be received by 5 PM September 30, 2006. Not responsible for lost or misdirected entries. Winners will be drawn from all valid entries no later than October 10th. Winner will be notified via email of award. By entering drawing you agree to subscribe to the VITAL FORMULATIONS, INC. E-newsletter, Your Vital Health News. All information is kept strictly confidential (see our privacy policy). No information is ever sold or distributed to any third party source.

* The information contained in this web site, including product descriptions, is intended for educational purposes only. It is not intended as a substitute for personal medical attention, or as a prescription for a specific health condition or illness. Neither Dr. Hansen, Vital Formulation, Inc. shall be held liable or responsible to any person or entity for the claim of any loss, damage, or injury due to the health information or inferred health recommendations contained in this web site.

Our other websites are: www.adhd-drugfreealternatives.com and www.DrHansen.com