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Please tell us about your experience in a PURE Room.  To thank you for your time you will be entered to win a purifier for your home.
* 1. In which PURE Room hotel did you stay and what City?
     
   Hotel Name  Hotel Location
* 2. How did you hear about PURE Rooms?
 Friends or Colleagues
 Front Desk
 Internet
 Hotel Website
 Other 
* 3. What is the primary reason you chose to stay in a PURE Room?
 Suffer from allergies
 Suffer from asthma
 Other medical condition  
 General health
 Supporting "Green" Initiatives
 Other 
* 4. Did you notice a positive difference in the PURE Room?

Big difference
Small difference
No difference
 5. Was there an upcharge to stay in a PURE Room?
 Yes
 No
* 6. Would you recommend PURE Rooms to friends?

Definitely
If it came up in conversation
Maybe
Not Likely

 7. Male or Female

Male
Female
8. Age Group

Under 25
25-44
45-64
65+
9. How often do you travel?

Once a year
2-5 times per year
6-10 times per year
More than 10 times per year
10. What is your primary reason for travel? Check all that apply.

Business
Leisure
Family Travel
11. If you have any other questions or comments for PURE, please write them here:
* Full Name:
Street Address, City, State & Zip:
* Email:
* Would you like to receive a monthly newsletter from PURE?
Yes
No
 
12. If yes, what would interest you? Check all that apply:

Special offers from hotels with PURE Rooms
Asthma and Allergy Tips
Information on hotels offering PURE
Other 

 
13. Would you be interested in joining PURE in Social Networking? Check all that apply:

Facebook
Twitter
Other 

 Phone Number:
 (To be used to contact winner of purifier)

 

Thank you for taking the time to share your experience in a PURE Room! We do hope you will visit this site to find a PURE Room for your next hotel stay.

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Feedback provided may be used for the promotion of PURE Rooms. No identifying information will be disclosed and contact information will be kept confidential – we highly respect our privacy and know you do the same.
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