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Survey about therapists, health insurance, road rage, psychiatrists, laugh and car accidents.

Begin Survey

1. Do you have road rage? Yes No

2. Do you take a bagged lunch to work every day? Yes No

3. Do you have health insurance? Yes No

4. Do you enjoy gambling? Yes No

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

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

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

8. Have you ever had a professional massage? Yes No

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

10. Do you own a gun? Yes No

11. Are you involved in volunteerism? Yes No

12. Do you drink diet soda? Yes No

13. Have you ever been in a car accident? Yes No

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

15. Do you enjoy roller coasters? Yes No

16. 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: - Blueberry Jelly Bellies were created especially for Ronald Reagan. - Coca-Cola was the first soft drink to be consumed in outer space. - Children laugh about 400 times a day, while adults laugh on average only 15 times a day. - The world’s first gas station was opened by the Gulf Refining Company on December 1, 1913, in Pittsburgh, Pennsylvania.

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