My Best Silhouette - Bra & Shapewear Survey

How did you hear about us?

If "other" explain how

Name

City or Town

Province

Day Phone Number (with Area Code)

Evening/Weekend Phone Number (with Area Code)

Best Time To Contact

Email

Current Bra Style & Size

What frustrates you most?
Bust spills out from the top, bottom/sides of bra
Bra cups pucker and feel too loose
Bra feels too tight
Bra rides up in the back
Bra accentuates "back fat"
Bra shoulder staps constantly fall down
Bra shoulder straps dig into your shoulders
Your bras lose shape?
You have a drawer full of bras
Your breasts are sitting on the tummy

Are you experiencing any of the following?
Do you bounce?
Is your breast tissue sagging?
Do you experience back pain?
Do you have poor posture?
Do you wear a Sport's bra periodically?
Are you a mother-to-be or presently nursing?

How often do you purchase a bra?

Have you ever had breast surgery?

Do you wear a prosthesis, foam or insert?

Would you be interested in having a free, professional bra fitting?
Yes
No

If not, why?

Are you interested in attending a Party/Clinic"
Yes
No

Are you interested in hosting a Bar Party/Clinic or Fundraiser?
Party/Clinic
Fundraiser

What do you want to find out from having a professional bra-fitting?

What do you want our Jeunique bras & shapewear to do for you?
Enhance my breast size
Reduce appearance in breast size
Improve posture
Reduce neck or back pain
Eliminate bouncing when exercising
Create a smooth, seamless silhouette
Make clothes fit better

What would you like to change?

Your Waist

Your Stomach

Your Hips

Your Derriere

Jeunique custom-fit bras will change the way you look and feel. We have fitted and helped thousands of women! Now it’s your turn to give us a chance! Get in touch with us today!

If you are currently wearing a Jeunique bra and would like to be re-sized, order a new bra or ask a question, please fill in your needs.

We respect your privacy and your information will never be shared with any other party.