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Survey about medications, airplanes, cows, work, central park and love.

Begin Survey

1. Do you smoke cigarettes? Yes No

2. Do you ever dye your hair? Yes No

3. Do you suffer from seasonal allergies? Yes No

4. Do you believe in love at first sight? Yes No

5. Do you plan on visiting a comedy club this month? Yes No

6. Do you take any prescribed daily medications? Yes No

7. Do you have road rage? Yes No

8. Have you ever traced your family tree? Yes No

9. Do you enjoy playing video games? Yes No

10. Do you plan on taking a trip by airplane this week? Yes No

11. Do you enjoy gambling? Yes No

12. Do you enjoy cat-naps? Yes No

13. Do you drink milk? Yes No

14. Do you contribute money to any charitable organizations? Yes No

15. Do you take a bagged lunch to work every day? Yes No

16. 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: - James Garfield was the first U.S. president to use a telephone. - Coca-Cola was the first soft drink to be consumed in outer space. - You are more likely to get attacked by a cow than a shark. - New York's Central Park is nearly twice the size of the entire country of Monaco.

Related Content: MEDICATIONS ON AIRPLANES

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