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Survey about xbox, smoking, hiv, radio, shower and winter.

Begin Survey

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

2. Do you drink milk? Yes No

3. Do you smoke cigarettes? Yes No

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

5. Do you ever dye your hair? Yes No

6. Do you eat lunch every day? Yes No

7. Do you know how to fly an airplane? Yes No

8. Do you have any tattoos? Yes No

9. Do you listen to talk radio? Yes No

10. Will you consume any alcoholic beverages this weekend? Yes No

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

12. Have you ever taken dance lessons? Yes No

13. Do you enjoy roller coasters? Yes No

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

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

16. Do you suffer from seasonal allergies? Yes No

17. Do you practice yoga? Yes No

18. Do you shower at least once daily? Yes No

19. Do you enjoy documentary films? 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: - Babe Ruth wore No. 3 because he batted third. - Almonds are a member of the peach family. - The average American consumes 9 pounds of food additives every year. - The are six fictional characters that have stars on Hollywood's 'Walk of Fame'.

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