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Survey about doctors, eyes, cappuccino, multi-vitamin, coffee house and spicy food.

Begin Survey

1. Have you ever spent a day at a spa? Yes No

2. Will you buy an espresso drink (cappuccino, latte etc.) from a coffee house this week? Yes No

3. Do you own your own business or work for yourself? Yes No

4. Do you enjoy spicy foods? Yes No

5. Do you own a motorcycle? Yes No

6. Would you consider yourself an avid sports fan? Yes No

7. Will you attend a professional sporting event this month? Yes No

8. Do you enjoy reading non-fiction books for pleasure? Yes No

9. Will you visit a casino this week? Yes No

10. Do you have any siblings? Yes No

11. Do you have cable or satellite television? Yes No

12. Have you ever gotten a traffic ticket? Yes No

13. Do you give your children a daily multi-vitamin? Yes No

14. Are your immunizations up-to-date? Yes No

15. Have you ever been in love? Yes No

16. Will you visit a doctor this week? Yes No

17. Would you like a free video or CD-ROM with more information on owning or renting an RV? Yes No

Your Firstname:

Your Emailaddress:

Yes, I would like to join the Daily Life Survey!

Fun and Interesting facts: - Leonardo da Vinci invented scissors. - In 2003, the U.S. Government spent about $2,000,000 on potato research. - One in 500 humans has one blue eye and one brown eye. - Hawaii has the only royal palace in the United States – Iolani.

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