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1. Oral Hygiene - May 2011

Thank you for taking the time to answer these brief questions. As always, we appreciate your input as a valuable Plaza Research respondent. We have a new study on ORAL HYGIENE that you maybe in interested in.

Please take note that you are ineligible to participate if you have taken part in any research study in the last 6 months.

We are looking for males and females ages 25-35. This is a 2-part study consisting of a 2-week product trial followed by a 20-minute individual interview in downtown San Francisco between Sunday, May 15th thru Tuesday, May 17th. The honorarium is $150.00 if you qualify and participate.

IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone.

Please note that all responses will be returned on a first come, first served basis until the studies are full.

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* 1. Contact Information

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* 2. Employment Information

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* 3. What is your gender?

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* 4. Which of the following groups best fits your age?

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* 5. What is your EXACT age?

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* 6. What is your current employment status?

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* 7. Which of the following best describes your current living situation?

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* 8. Which of the following best describes your ethnic background?

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* 9. Do you have any children? If yes, how many?

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* 10. Do you have or believe that you are at risk for any of the following (select all that apply):

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* 11. How often do you exercise?

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* 12. Do you consume the following regularly?

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* 13. Do you CURRENTLY use any of the following products (select all that applies)?

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* 14. Rate the product(s) you use on a scale of 1-10 (1 being not helpful at all, 10 being extremely helpful):

  Not helpful at all Extremely helpful N/A
Crest Pro Health Enamel Shield
Colgate Total Enamel Protect
Arm & Hammer Enamel Care
ProNamel
Other

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* 15. Check all of the following statements that are applicable to your life.

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* 16. Check all of the following statements that are applicable to your life.

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* 17. Is using a toothpaste that provides whitening important to you? Are having white teeth important to you?

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* 18. Is using a toothpaste that provides whitening important to you? Are having white teeth important to you?

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* 19. What are your hobbies, activities, passions?

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* 20. Do you visit the dentist/hygienist at least 2 times per year?

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* 21. Part of this Market Research involves a product trial. If selected, we would like you to use the product for the next two weeks. Use it every day, twice a day, replacing your regular product We will ask you to keep some notes on how the product feels, tastes, etc. We will then bring you in for the interview, where we will ask you questions about your experience.

Are you willing to do this?

**IMPORTANT: PLEASE PUSH THE "DONE" BUTTON AT THE BOTTOM OF THIS SCREEN. YOUR ANSWERS WILL NOT BE SAVED WITHOUT DOING SO!**

Thank you for participating in our survey. IF you qualify based on the answers provided THEN you will receive a call back. However due to the popularity of our surveys and groups, we can't contact everyone. Please note that all responses will be returned on a first come, first served basis until the studies are full.

*****REFERRALS ARE GREATLY APPRECIATED!*****

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* 22. ******FOR COMPANY USE ONLY******
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