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* 1. What is your first AND last name?

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* 2. What is your primary phone number?

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* 3. What is your secondary phone number?

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* 4. What is your age?

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* 5. What is your current employment status?

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* 6. In the past year, which of the following oral care products have you purchased AND used?

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* 7. In an average day, how often do you brush your teeth?

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* 8. How many of your own teeth do you have?

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* 9. Are you currently using any of the following?

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* 10. What best describes your ethnic background?

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* 11. What is your total annual household income before taxes are taken out?

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* 12. Do you have a working computer with reliable high-speed internet access?

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* 13. In what state do you currently reside?

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