31%
Health Condition Study #3819
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are required
Contact Information
First Name
Last Name
Phone
Email Address
Address Line 1
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
District of Columbia
Zipcode
What is your current age?
What is your gender?
Male
Female
Have you or has anyone in your household ever been employed by any of the following:
Advertising, public relations, design, including web design
Marketing or marketing research
By the news media, such as television, radio or a newspaper
Company that manufactures, markets, or distributes metered-dose inhaler products/devices
Healthcare
Hospitality
None of the above
When was the last time you participated in a market research study?
Are you currently scheduled to participate in any market research study?
Yes
No
Do you currently own
and regularly
use
a
metered-dose inhaler (MDI)
?
Yes
No
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