| FEINGOLD ASSOCIATION OF THE U.S. |
| FRAGRANCE SURVEY |
| In your Foodlist under the Non-Food heading, natural and masking fragrances are discussed. As you know, very few products with natural fragrance are allowed into the Foodlist & Shopping Guide, but we suggest that members can test them out individually if they so choose. |
| At this time the Product Information Committee would like to inquire specifically about naturally fragranced items. We want to know if there were any reactions or if your family can successfully use any particular product. |
| We would like for you to fill out this survey. |
| Have you been using any products with natural fragrance? We are looking for products that are not yet in the Foodlist that you have experimented with on your own. For each product you have been using please list: |
| Please complete this survey for as many products as you choose. We want to contact these manufacturers and get information regarding the products in order to put out a more detailed survey at a later date. Thank you for your assistance. We look forward to hearing from you Product Information Committee Feingold Association of the U.S. |
| Are you sensitive to fragrance? |
| If you are please choose which kind. |
| Name of Product |
| What scent or variety - Example: Lemon, Winter Wonder, Lavender |
| Please post for us the Manufacturers Information so we can contact the company. |
| Phone |
| Address |
| Web Address |
| Fax |
| How long have you used this product? |
| Have you seen any reaction? |
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