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Online Coffee Study with Superior Focus
1.
Please fill out the following information so we may contact you.
Name
Company
City/Town
State/Province
Email Address
Phone Number
2.
Please describe your gender
MALE
FEMALE
TRANSGENDER
IDENTIFY AS SOMETHING OTHER THAN MALE/FEMALE/TRANSGENDER
PREFER NOT TO ANSWER
3.
What is your age?
4.
Which of the following best describes your ethnic background?
Caucasian/White
African American
Hispanic/Latino
Asian
Other (please specify)
5.
How many times a week would you say you drink coffee?
Less than three times a week
3 to 4 times a week
5 to 7 times a week or more
6.
How is the coffee you drink at home usually prepared THAT YOU CONSUME YOURSELF?
Automatic Drip Coffee maker
French Press coffee maker
Pour over coffee maker
Percolator
A single-cup coffee brewer (like Keurig, Tassimo)
Instant coffee (Hot water + Instant coffee “grounds”)
Stove top or manual Espresso-maker
Automatic Espresso-maker (like Nespresso)
7.
Which, if any of the following types of coffee would you say you drink REGULARLY?
Hot Coffee
Iced or Cold Coffee
Hot coffee drinks such as cappuccinos, lattes, etc.
Iced or Cold coffee drinks such as iced lattes, iced cappuccinos, etc.