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Market Research Template
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1.
What is your age?
(Required.)
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 to 74
75 or older
*
2.
What is your gender identity?
(Required.)
Man
Woman
Non-binary
Prefer to self-describe (please specify)
*
3.
How much total combined money did all members of your HOUSEHOLD earn last year?
(Required.)
$0 to $9,999
$10,000 to $24,999
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $124,999
$125,000 to $149,999
$150,000 to $174,999
$175,000 to $199,999
$200,000 and up
Prefer not to answer
*
4.
Do you currently take recurring medications?
(Required.)
Yes
No
*
5.
How often do you need to refill your medication
(Required.)
Weekly
Monthly
2 Months
3 Months
Other (please specify)
*
6.
How well does your doctor explain how to take your medicine(s)?
(Required.)
Extremely well
Very well
Somewhat well
Not so well
Not at all well
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7.
Rate the features below you would want to see available by using a smart pill bottle
(Required.)
Not interested
Somewhat interested
Neutral
Very Interested
Want it now
Automatic refills
Dosage reminders
Reminder light on bottle
Reminder Chime on bottle
Cell phone app
More details available on medications in app
Locking lid
Fingerprint unlock
Medication remaining
Rating effectiveness of medication
Medication dosing history
Direct connection to emergency services for vulnerable medication
Monitor medication of child or senior
Comprehensive drug list with dosage requirements
Remote unlock through app
Other (please specify)
*
8.
How much would you pay for access to the services above?
(Required.)
$200 for reusable pill bottle and $3.99 per month for service
$200 for pill bottle with no cloud services (only connects to smart phone with limited services)
$7.99 per month per medication including reusable smart bottle
$24.99 per month for up to 4 medications including reusable smart pill bottles
*
9.
Which of the following are reasons that you might purchase this product? Please select all that apply.
(Required.)
It is better quality than something I already use
It is a better price than something I already use
I purchased something similar in the past but need to replace it
It would make a good gift
It serves a need of mine that is not currently being met
Other (please specify)
*
10.
Which of the following are reasons that you might not purchase this product? Please select all that apply.
(Required.)
I don’t want something like this
I don’t need something like this
I purchased something similar and I am satisfied
I don’t know anyone who would want this
It is too expensive
It is low quality
Other (please specify)
*
11.
If this product were available today, how likely would you be to purchase it instead of competing products currently available from other companies?
(Required.)
Extremely likely
Very likely
Somewhat likely
Not so likely
Not at all likely
12.
Redeem the following Survey Code at https://www.surveycircle.com and get free survey participants through SurveyCircle. The Survey Code is: JTDW-MMX9-YZP5-U6Y5
Current Progress,
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