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Survey about restaurants, health, multi-vitamin, playstation 2, medications and teeth.

Begin Survey

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

2. Do you own a console video game system (Xbox, Playstation 2, GameCube, etc.)? Yes No

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

4. Have you ever been arrested? Yes No

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

6. Do you enjoy cooking or baking? Yes No

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

8. Will you be staying at a hotel this week? Yes No

9. Will you attend religious services this week? Yes No

10. Did you vote in the last Presidential election? Yes No

11. Do your children attend public schools? Yes No

12. Will you buy a lottery ticket this week? Yes No

13. Do you think professional athletes should be regularly screened for illicit drug use? Yes No

14. Do you brush your teeth before bed each night? Yes No

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

16. Have you ever eaten fried green tomatoes? Yes No

17. Do you get a flu shot every winter? Yes No

18. Do you enjoy hunting or fishing? Yes No

19. Do you have a DVD player? 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: - Mr. Rogers was an ordained minister. - The average American eats approximately 20 pounds of pasta each year. - Children laugh about 400 times a day, while adults laugh on average only 15 times a day. - The State of Nevada's name comes from the Spanish meaning 'snow-capped'.

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