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Survey about hiv, car accidents, statue of liberty, cranberry juice, relatives and flu.

Begin Survey

1. Do you get a flu shot every winter? Yes No

2. Do you think you are physically attractive? Yes No

3. Have you ever been tested for HIV? Yes No

4. Will you consume any alcoholic beverages this weekend? Yes No

5. Do you own at least one pair of blue jeans? Yes No

6. Have you ever been in a car accident? Yes No

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

8. Do you drink milk? Yes No

9. Will you plant a vegetable and/or flower garden this year? Yes No

10. Are any of your grandparents still alive? Yes No

11. Do you subscribe to your local newspaper? Yes No

12. Have you ever borrowed money from a relative? Yes No

13. Do you think professional athletes should be regularly screened for illicit drug use? Yes No

14. Do you have road rage? Yes No

15. Do you belong to a labor union? Yes No

16. Will you attend a college sporting event this month? 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: - Jackie Kennedy Onassis was secretly a chain smoker. - The Massachusetts state beverage is Cranberry Juice. - By the age of 60, most people have lost 50% of their taste buds. - The first lighthouse to use electricity was the Statue of Liberty in 1886.

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