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2014
February
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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
*
First Name
:
*
Last Name
:
*
Email Address
:
What is your gender?
Male
Female
What is your age?
Younger than 18
18 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
Prefer not to answer
What is your marital status?
Single (Never married)
Married
Domestic partnership
Widowed
Divorced
Separated
Don’t know
Which of the following categories best describes the industry you work in?
Automotive
Advertising
Consulting Services
Education
Entertainment
Financial Services
Government Services
Healthcare
Human Resources
Information Technology
Marketing/Sales
Non-Profit
Pharmaceuticals
Public Relations
Technical Services
Travel
Other
What is the highest level of education you have achieved?
Less than high school degree
High school degree or equivalent (e.g. GED)
Some college but no degree
Associate degree (e.g. AA, AS)
Bachelor's degree (e.g. BA, AB, BS)
Master's degree (e.g. MA, MS, MBA)
Professional degree (e.g. MD, DDS, JD)
Doctorate degree (e.g. PhD)
Which category best describes your annual income?
Under $15,000
$15,000 - $29,999
$30,000 - $44,999
$45,000 - $59,999
$60,000 - $74,999
$75,000 - $89,999
$90,000 - $104,999
$105,000 - $119,999
$120,000 or more
Prefer not to answer
How often do you drink tea?
Once a week
Once a month
Once a year
Seasonally
Never
When do you drink tea? (Select all that apply)?
In social settings
At night
Before you go to work
How often do you get massages?
Once a week
Once a month
One a year
Never
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