Thursday, March 11, 2010

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Personalized nutritional programs and products for professionals and their dieters.

Robard, the Company / Contact Us /

Contact Robard Corporation

If you'd like to learn more about Robard's programs and products for your business, call our Business Development Department at 800.222.9201 or complete the form below.

If you are an individual looking for a weight loss program in your area that carries Robard products, please complete the first section of the form below.

* (asterisk) indicates a required field.

Contact information:

Salutation
* First Name
* Last Name
* Company
* Street address
* City
* State
* Zip
E-mail
* Business Phone	Ext.
Cell Phone
Business Fax
Website
* How did you hear about us?
-

I am a: (required)

Physician Specialty
Nurse
Registered Dietitian
Behaviorist
Office Manager
Administrator
Dieter‡
Other

‡Robard Corporation does not sell nutritional products directly to dieters. If you are a dieter in search of a weight loss program or products, please select "Dieter" from above and we will have our Robard professionals contact you with more information on helping you meet your goals.

As a dieter, please let us know 2 closest cities nearest you.

What is the closest town nearest you?

What is the largest city nearest you?

I am interested in learning more about Robard's (check all that apply):

Programs:
New Direction System (Very Low Calorie Diet)
NutriMed (Very Low Calorie Diet)
Advanced Health Systems (Low Calorie Diet)
Private Label Program

Services:
Business Development
Marketing Support
Staff Training
Patient/Client Education
Expansion of Product Line

Products:
Meal Replacement Products
Protein Supplements
Dietary Enhancers

If you are currently running a weight loss program please answer the following:

Is your program part-time or full-time? Full-timePart-time
Do you currently offer a VLCD or LCD program? VLCDLCD

Do you currently sell protein supplements? YesNo
Do you currently write prescriptions or dispense obesity medications? YesNo
How many locations do you have?

Is this program located in a: Private PracticeHospitalRetail Clinic

Are your products private labeled? YesNo

If you are not currently running a weight loss program please answer the following:

What type of program are you considering offering? VLCDLCD
When do you anticipate your program opening?

In your program, will protein supplements be: MandatoryVoluntaryUndecided

Are you interested in private labeling? YesNo

Please answer the following questions:

Are you interested in a very low calorie diet (weight loss up to 5 lbs per week on average) or a low calorie diet (weight loss up to 3 lbs per week on average)?
Very Low Calorie Diet (medically supervised)
Low Calorie Diet
Unsure
Ideal weight lost partner involves Weekly visits to a hospital program
Weekly visits to a doctors office
Weekly visits to a non-medical clinic
Internet program (low calorie diets only)
If you want a program that offers weekly visits, would you prefer one that provides: Group support
One on one support

What is the best way to reach you?

Business Phone	In the morning	In the afternoon
Cell Phone	In the morning	In the afternoon
Email

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