Focus Survey Information Request Form
Focus Surveys

CAUTION: Before filling out the form below, go to our "Qualified Inquiries" page. Then, if you believe that our services are still appropriate for you, return here to complete the form. Thank you.

Special Notes: We do not send out free copies of our surveys. Instead, we provide information about how our service works. Also, the minimum price for our Standard Survey (20 questions for 20 respondents) is $995, which includes printing and sending you the surveys, analyzing the results, giving you back a final report, printing color charts of the results, etc. If you are not prepared to pay for this service, then this service is not for you.

YES, I still want to see for myself how a customized, ready-to-go survey by Focus Surveys® can work for us. Send me information about a:

Please mark only One survey
Send me information about the survey I marked above to:
State    Zip

(Only qualified inquiries for information can be accepted. Also, Focus Surveys® are currently available only in the United States.)