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Survey about medications, psychiatrists, growing, houseplants, cologne and dvds.

Begin Survey

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

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

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

4. Do you enjoy independent films? Yes No

5. Are you currently attending college or taking adult enrichment classes? Yes No

6. Have you ever won the lottery? Yes No

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

8. Do you wear glasses/contacts? Yes No

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

10. Do you plan on performing any community service this week? Yes No

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

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

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

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

15. Do you have any houseplants? Yes No

16. Have you ever purchased or sold anything on eBay? Yes No

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

18. Do you wear mittens? Yes No

19. 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: - Henry Ford, father of the assembly line, also invented the charcoal briquette. - Coca-Cola was the first soft drink to be consumed in outer space. - The human brain stops growing at the age of 18. - On a clear day, you can see five states from atop the Empire State Building in New York City: New York, New Jersey, Connecticut, Massachusetts, and Pennsylvania.

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