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Survey about low-carb diet, coffee house, meditation, overall health, hair and medications.

Begin Survey

1. Do you know how to fly an airplane? Yes No

2. Do you follow a vegetarian diet? Yes No

3. Would you consider yourself to be in good overall health? Yes No

4. Have you ever cut your own hair? Yes No

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

6. Do you ever use a tanning bed? Yes No

7. Have you ever been the target of identity theft? Yes No

8. Do you have any food allergies? Yes No

9. Do you follow a low-carb diet? Yes No

10. Do you practice yoga? Yes No

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

12. Do enjoy reading or writing poetry? Yes No

13. Do you own your home? Yes No

14. Do you enjoy independent films? Yes No

15. Will you rent a DVD or video this weekend? Yes No

16. Do you take any prescribed daily medications? 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 was dyslexic. - Approximately 3 billion pizzas are sold in the U.S. each year. - After the age of 35, about 1 in 27 women will give birth to twins. After 50, the chances of having twins is 1 in 9. - The White House kitchen, with its five full-time chefs, is able to serve as many as 140 dinner guests, and hors d’oeuvres to more than 1,000 people.

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