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Survey about pda, latte, cpr, coffee house, cappuccino and teeth.

Begin Survey

1. Do you have or use a PDA (Personal Digital Assistant)? Yes No

2. Do you have any food allergies? Yes No

3. Do you know CPR? Yes No

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

5. Will you order take-out or delivery food from a restaurant this week? Yes No

6. Do you follow a vegetarian diet? Yes No

7. Do you ever dye your hair? Yes No

8. Do you brush your teeth after lunch? Yes No

9. Do you read your horoscope every day? Yes No

10. Do you enjoy hot bubble baths? Yes No

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

12. Do you take a daily multi-vitamin? Yes No

13. Do you attend regular religious services? Yes No

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

15. Do you enjoy ethnic foods? Yes No

16. Do you own a motorcycle? Yes No

17. Do you have any siblings? Yes No

18. Do you have an annual check-up or exam with your family doctor? Yes No

19. Will you visit a casino this week? Yes No

20. 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: - Al Capone's business card said he was a used furniture dealer. - Lima beans contain cyanide. - During their lifetime, the average human will grow 590 miles of hair. - Manhattan Island of New York City was purchased for $24 from the Algonquian Indians in 1624.

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