Bra & Shapewear Survey
To better serve you please fill out the form below for more information.
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How did you hear about us?
Customer
Hostess
Newspaper
Website or Internet Search
Referral
Other
Name of newspaper or referrer
If "other" explain how
Name
City or Town
Province
Manitoba (MB)
Alberta (AB)
British Columbia (BC)
New Brunswick (NB)
Newfoundland and Labrador (NL)
Northwest Territories (NT)
Nova Scotia (NS)
Nunavut (NU)
Ontario (ON)
Yukon (YT)
Prince Edward Island (PE)
Quebec (QC)
Saskatchewan (SK)
Day Phone Number (with Area Code)
Evening/Weekend Phone Number (with Area Code)
Best Time To Contact
AM
PM
Email
Current Bra Style & Size
What make of bra do you wear most often?
What do you normally pay for your bras?
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
Approximately, how many bras do you purchase in a year?
Approximately, how many bras do you own right now?
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?
Have you ever had breast surgery?
Lift?
Reduction?
Implants?
Mastectomy/Lumpectomy?
None?
Do you wear a prosthesis, foam or insert?
Prosthesis
Foam
Insert
None
I am interested in the following
Having a private personal custom-fitting
Hosting a clinic / party / fundraiser
Elaine speaking at my workplace, meeting or event
What do you want to find out from having a professional bra-fitting?
Determine my correct bra size
Find a bra that best suits your body shape and bre
Fine-tune my present bra fit by suggesting alterna
Find a better fit – without underwire
Or all of the above
What do you want our 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
Smaller
Eliminate Bulge
Your Stomach
Flatten stomach
Better support
Firmer
Your Hips
Minimize
Firm
Your Derriere
Lift
Redirect
Firm
Our 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 or Tab 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.
For more information contact Elaine@ MY BEST SILHOUETTE
1-866-689-8094 Email:
info@mybestsilhouette.com
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