Alcohol Testing - Acrobat (309298) Question Title * 1. Address Name Email Address Phone Number Question Title * 2. Occupation Question Title * 3. QQ1. Are you… Male Female Question Title * 4. QQ2. And how old are you…? Question Title * 5. QQ3. We are looking for people who work in certain occupations. Can you please tell me if you or any member of your household, relatives or close friends work in any of these professions or industries? Advertising/sales promotion/design Journalism Marketing/market research New product development Public relations Manufacture or sale of alcohol TV/Radio/Press None of these Question Title * 6. QQ4.Have you participated in any market research studies in the last three months? Yes No Question Title * 7. QQ5. Are you currently pregnant or breastfeeding? Yes No Question Title * 8. QQ6. Which of the following types of beverages do you regularly drink? Alcoholic Beverages Fruit Juices Smoothies Milkshakes Hot Drinks Energy Drinks Soft Fizzy Drinks (Coke, Pepsi etc) Other (please specify) Question Title * 9. QQ7. Do you have any allergies / intolerances related to alcohol? Yes No Question Title * 10. Which of the following alcoholic beverages do you regularly drink at a pub/bar/club/restaurant? Beer Non-alcoholic Beer Wine Liquors (e.g. fruit, cream, herbal) Vodka Whisky Rum Gin Tequila Other None of the above Question Title * 11. Which of the following alcoholic beverages do you regularly drink at home? Beer Non-alcoholic Beer Wine Liquors (e.g. fruit, cream, herbal) Vodka Whisky Rum Gin Tequila Other None of the above Question Title * 12. QQ9a. Which of the following brands of beer have you drank in the last 3 months? Guinness Draught Heineken lager Coors Light Carlsberg lager Budweiser lager Smithwick’s Ale Carling lager Corona Tennents lager Hop House 13 Rockshore lager Foster’s Peroni Stella Artois John Smith’s San Miguel Amstel Other None of the above Would consider all Question Title * 13. QQ9b. Which of the following brands of beer do you regularly drink? Guinness Draught Heineken lager Coors Light Carlsberg lager Budweiser lager Smithwick’s Ale Carling lager Corona Tennents lager Hop House 13 Rockshore lager Foster’s Peroni Stella Artois John Smith’s San Miguel Amstel Other None of the above Would consider all Question Title * 14. QQ9d. Which of the following brands of beer would you NEVER consider? Guinness Draught Heineken lager Coors Light Carlsberg lager Budweiser lager Smithwick’s Ale Carling lager Corona Tennents lager Hop House 13 Rockshore lager Foster’s Peroni Stella Artois John Smith’s San Miguel Amstel Other None of the above Would consider all Question Title * 15. QQ10a.Which of the below statements best applies to you? I never consider things like sugar content or calories when I’m drinking alcohol I sometimes consider things like sugar content or calories when I’m drinking alcohol I often consider things like sugar content or calories when I’m drinking alcohol Question Title * 16. Do you confirm that you will not drive home after this test? Yes No Question Title * 17. Do you confirm that you will regulate your alcohol intake over the period of this research to not exceed the recommended weekly alcohol intake of no more than 14 units per week? Yes No Question Title * 18. What time slots are you available for? (please note we will contact you to confirm) 4.30pm 5pm 5.30pm 6pm 6.30pm 7pm 7.30pm Question Title * 19. Recruiters Name Question Title * 20. We are looking for people to take part in research about alcoholic beer. This would involve you attending a 10 minute session at central location . At this session, you will be asked to assess 1 beer and answer some questions about them. Please note that if you take part in this research you will be required to last the duration of the survey without smoking.Please bring a valid form of photo ID to be checked at the hall (e.g. passport or driving licence)Please see www.DrinkIQ.com for more information about responsible drinking.Are you willing to take part in this research, and available the date specified? Yes No Done
