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Survey about overall health, pennsylvania, doctors, love, travel and dvds.

Begin Survey

1. Do you enjoy reading non-fiction books for pleasure? Yes No

2. Do you have Internet access at home? Yes No

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

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

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

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

7. Do you know your cholesterol level? Yes No

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

9. Do you own a matching set of luggage? Yes No

10. Do you listen to talk radio? Yes No

11. Have you ever broken any bones? Yes No

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

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

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

15. Would you consider yourself an avid sports fan? Yes No

16. Do you enjoy gambling? Yes No

17. Will you visit a doctor this week? Yes No

18. Do you like peanut butter and jelly sandwiches? Yes No

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

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

21. 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: - Jimi Hendrix, Janis Joplin, and Jim Morrison were all 27 years old when they died. - Tootsie Rolls were the first wrapped penny candy in America. - Only 1 person in 2 billion will live to be 116. - 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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