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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.

 
 
 
 
Name
   
 
 
 
Postcode
   
 
 
 
Age range?
 
Less than 18
 
18-25
 
26-35
 
36-45
 
46-55
 
56-65
 
66-75
 
76-85
 
Over 85
 
Other
 
 
 
 
What is your normal source of drinking water?
 
Straight from the tap
 
Filtered tap water
 
Rain water
 
Bottled/spring water
 
Other
 
 
 
When did you last have a drink of water straight from the tap - no filtration?
 
Today
 
Within the past two days
 
Within the past week
 
More than a week ago
 
 
 
How satisfied are you with the taste of your tap water?
Very Dissatisfied
Dissatisfied
Neither satisfied nor dissatisfied
Satisfied
Very Satisfied
 
 
 
How satisfied are you that our tap water is safe to drink?
Very Dissatisfied
Dissatisfied
Neither satisfied or dissatisfied
Satisfied
Very Satisfied
 
 
 
How satisfied are you with the clarity of your tap water?
Very dissatisfied
Dissatisfied
Neither satisfied nor dissatisfied
Satisfied
Very Satisfied
 
 
 
How satisfied are you with the colour of your tap water?
Very Dissatisfied
Dissatisfied
Neither satisfied nor dissatisfied
Satisfied
Very Satisfied
 
 
 
How satisfied are you with the smell/odour of your tap water?
Very Dissatisfied
Dissatisfied
Neither satisfied nor dissatisfied
Satisfied
Very Satisfied
 
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