Whitening/Toothbrush Recruitment-Craigslist

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5% of survey complete.

Welcome! Thank you for your interest in our product test center. In order to make our products the best they can be we reach out for feedback to folks like you so we can ensure we are delivering a best in class experience.

Please complete the following questionnaire if you would like to be considered for future studies. It should only take about 5 minutes. You will then be added to the Philips Oral Healthcare Research database and we will contact you about upcoming product study opportunities.

If you have any questions or concerns please contact us at sonicareresearch@philips.com. We will never contact you to sell you products or services and your information is kept strictly confidential. We don't share your information with any other organizations.

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1. Contact Info

First Name:

Middle Initial:

Last Name:

Address:

City:

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2. State:

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3. Contact Information continued

Zip Code

Contact Phone

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4. Email Address

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5. Birthdate (MM/DD/YYYY)

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6. What is your gender

Male

Female