Please give us your feedback

To make the feedback process as simple as possible we have set up this page so you can provide us with specific feedback about what worked, and what didn't work for you on WELLalarm.com during our Beta Period.  You don't need to fill out all the fields, but the more information you can give us, the better. We'll use your feedback to improve the Web site and technology.

This form is set up to take specific reports on functionality, but you're welcome to just provide comments or suggestions in the "details" field at the end of the form.

Thank you for your input -- and thanks for helping us build a better WELLalarm.com


What page were you on?
Copy and paste the URL from the address bar if possible:
What were you trying to do?
e.g. Add item to cart, fill out a medication in your profile
What happened? Be as detailed as possible!
Please provide any other details
If you were subscribing, which service level?
If you were purchasing, which product?
If you were working on your profile, what specific item were you adding/removing?
What email address were you using?
Don't worry, we won't use this to contact you. We just want to be able to find your order/subscription in the database to troubleshoot.