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INTRODUCTION / 介绍:
Hello, good morning / afternoon / evening. My name is_______________. I’m an interviewer from Insight Research, a marketing research company. Now that you have tried the sample toothpaste for 2 weeks, I would like to ask you some questions related to the usage experience and product performance. The interview will be about 10 minutes. Your opinion and feedback will be very valuable for our survey.

您好,早安/午安/下午好.我的名字是_______________.我是来自Insight Research,一家市场调查公司的访问员.现在您已经试用了牙膏样本2个星期,我想问问您一些有关使用经验以及产品性能的问题.这个访问大约需要10分钟.您的意见以及反馈对我们的调查是非常宝贵.
 
 
Contact Information
First Name : 
Last Name : 
Address 1 : 
Address 2 : 
City : 
State : 
Zip : 
Phone : 
Email Address : 
 
 
 
RECORD RACE / 记录种族
 
 
 
RECORD AGE / 记录年龄
 
 
 
RECORD GENDER / 记录性别
 
 
You said that you have experienced some mouth conditions/problems in the past 3 months, how long have you been suffering from _________?



您提到在过去的3个月内,您曾经经历过一些口腔状况/问题,请问您经历_________已经有多久了?




 
Less than 1 year / 少过1年 1 year / 1年 2 years / 2年 3 years / 3年 4 years / 4年 5 years / 5年 More than 5 years / 超过5年
Bad breath / 口臭
Oral lit / 口腔上火
Gingival atrophy/Receding gums / 牙龈萎缩/牙龈退化
Mouth ulcers / 口腔溃疡
Gum bleeding / 牙龈出血
Swelling & inflammation of the gum / 牙龈肿痛和发炎