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Survey about tobacco, spa, religion, night, focus groups and organizations.

Begin Survey

1. Do you believe in miracles? Yes No

2. Do you attend regular religious services? Yes No

3. Do you have a swimming pool? Yes No

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

5. Will you visit a hardware or home improvement store this week? Yes No

6. Do you splash in mud puddles? Yes No

7. Do you belong to a credit union? Yes No

8. Have you ever participated in a focus group? Yes No

9. Do you have a savings account? Yes No

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

11. Do you ever dye your hair? Yes No

12. Have you ever cut your own hair? Yes No

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

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

15. Do you follow a low-carb diet? Yes No

16. Do you belong to any professional organizations? Yes No

17. Do you get between 7 to 10 hours of sleep each night? Yes No

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

19. 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: - Lyndon B. Johnson was the first president of the United States to wear contact lenses. - Coca-Cola was the first soft drink to be consumed in outer space. - The United States produces more tobacco than it does wheat. - The world's largest art gallery is the Winter Palace and Hermitage in St. Petersburg, Russia.

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