If you want to know our method before become too later

TO FILL UP THE FOLLOWING QUESTIONNAIRE

NEW LIFE INSTITUTE - S.O.S. TABAC
is in a position to offer You a free test
that permit You to know Your nicotine rate,
furthermore a detailed, free and without engagement information

 
Surname
Name
Address
N° ZIP
City Prov.
House phone Office phone
Profession Age

 
Questionnaire

How many years are You smoking?
How many cigarettes are You smoking in a day?
Brand of Your's cigarettes?
Is Your consort smoking?
YES NO
Have you already tried to give up smoking?
YES NO
Which method have You used?

We sure You that Your's personal data are treated with all reservedness with reference at Law in force (Law 675/96) ant its are exclusively utilized for our commercial proposal.

E-Mail: newlife@newlife.it