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Survey about road rage, disasters, tornados, first aid, mud puddles and coupons.

Begin Survey

1. Do you own or drive an SUV or large truck? Yes No

2. Do you believe in destiny or fate? Yes No

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

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

5. Do you have any tattoos? Yes No

6. Do you have cable or satellite television? Yes No

7. Have you ever been in a tornado, earthquake, or other natural disaster? Yes No

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

9. Do you own a first aid kit? Yes No

10. Will you be taking any road trips this week (over 50 miles)? Yes No

11. Do you splash in mud puddles? Yes No

12. Do you have children? Yes No

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

14. Do you have road rage? Yes No

15. Have you ever been tested for HIV? Yes No

16. Will you use a coupon for any of your purchases this week? Yes No

17. 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: - Deborah Winger did the voice of E.T. - Americans eat more than 22 pounds of tomatoes every year. - More children are allergic to cockroaches than cats - Ho-Ho-Kus, a small town in New Jersey, is the only town in the United States of America that has two dashes in its name.

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