* 1. What is your gender?

* 2. What is your age?

* 3. What is your full name?

* 4. In which region of the United States do you live?

* 5. What is your approximate average household income?

* 6. What is your first reaction to the product?

* 7. How would you rate the quality of the product?

* 8. How innovative is the product?

* 9. How often, if ever, do you currently use other, similar products?

* 10. If the product were available today, how likely would you be to buy the product?

* 11. When you think about the product, do you think of it as something you need or don’t need?

* 12. Which flavor do you like most?

* 13. When you’re considering new products in this area, what are the top two things you generally consider? (Check two boxes.)

* 14. In your own words, What will be the product cost?

* 15. How likely is it that you would recommend our new product to a friend or colleague?

Not at all likely
Extremely likely

* 16. In your own words, what are the things that you like most about this new product?

* 17. In your own words, what are the things that you would most like to improve in this new product?