Market Research - Product Testing Template

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* 1. How old are you?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 2. What is your gender?

Male

Female

Prefer not to say

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* 3. What is your annual income?

Under $15,000

Between $15,000 and $29,999

Between $30,000 and $49,999

Between $50,000 and $74,999

Between $75,000 and $99,999

Between $100,000 and $150,000

Over $150,000

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* 4. How often do you exercise?

Never

1-2x per week

3-4x per week

5-7x per week

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* 5. Are you conscious of what you eat?

Yes

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* 6. If you were to take a supplement, what would it likely be for?

Weight Management

Energy

Cognitive Performance (Mental Clarity, Focus, Memory)

Stress or Anxiety

Sleep

Sports Nutrition (pre-workout, protein, electrolytes, aminos)

Other (please specify)

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* 7. Are you currently on any medications or taking any supplements?

Yes

If yes - please describe the product and reason for taking it.

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* 8. If you were to take a supplement, where would you most likely purchase it?

Online

Supplement Store - like GNC

Walgreens / CVS

Independent Pharmacy

Grocery Store

Other (please specify)

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* 9. When choosing a supplement, which of the following matters most to you?

Clinical Research Performed on that Specific Product (Generally Rare for Supplements)

Formulated with all natural ingredients

Testimonials that the product works

Research Performed on the effects and/or benefits of each ingredient

Other (please specify)

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* 10. Which of the following do you deal with regularly?

Brain Fog

Lack of Focus

Difficulty Learning

Poor Memory

Stress

Anxiety

Depression

None of the Above