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Survey about health, gambling, multi-vitamin, life, doctor and louisiana.

Begin Survey

1. Do you have a land-line phone in your home? Yes No

2. Do you enjoy hot bubble baths? Yes No

3. Will you visit a hardware or home improvement store this week? Yes No

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

5. Do you take a daily multi-vitamin? Yes No

6. Do you think you are intelligent? Yes No

7. Do you drink enough water (6 8-ounce glasses) every day? Yes No

8. Do you enjoy gambling? Yes No

9. Will you visit a therapist or psychiatrist this week? Yes No

10. Do you believe there is life on other planets? Yes No

11. Do you wear cologne or perfume every day? Yes No

12. Have you eaten fast food this week? Yes No

13. Do you own a motorcycle? Yes No

14. Have you ever gone sky-diving or bungee-jumping? Yes No

15. Do you have an annual check-up or exam with your family doctor? Yes No

16. Do you enjoy spicy foods? Yes No

17. Do you have any tattoos? Yes No

18. 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: - Walt Disney named Mickey Mouse after Mickey Rooney, whose mother he dated for some time. - The U.S. Government spent $277,000 on pickle research in 1993. - Betty Rubble made her debut as a Flintstones Vitamin in 1996. - The State of Louisiana was named after the French King Louis XIV.

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