Focus Groups New York- Healthy Energy Beverages - January 2019

ENERGY DRINKS

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* 1. What's your email address?

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* 2. First Name:

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* 3. Last Name:

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* 4. Gender

Male

Female

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* 5. What is your exact age?

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* 6. Cell phone number you can be reached?

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* 7. Please select which best describes your race/ethnic background

Asian, Pacific Islander

African American

Hispanic/Latino

Native American

Caucasian

Multi-Racial

Otro (especifique)

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* 8. What is the highest level of education you've completed?

Less than High School

High School Grad

Equivalency/GED

Some College

Associates Deg/2yr College

Trade/Technical School

College Grad/4yr

Post Grad Work no degree

Post Grad Deg/Adv. Deg

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* 9. What is your current Marital Status?

Single

Married

Co- Habiting

Divorced

Seperated

Widowed

Focus Groups New York- Healthy Energy Beverages - January 2019

ENERGY DRINKS

Question Title

* 1. What's your email address?

Question Title

* 2. First Name:

Question Title

* 3. Last Name:

Question Title

* 4. Gender

Question Title

* 5. What is your exact age?

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* 6. Cell phone number you can be reached?

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* 7. Please select which best describes your race/ethnic background

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* 8. What is the highest level of education you've completed?

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* 9. What is your current Marital Status?

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* 10. Occupation Title

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* 11. In which area of the city do you live?

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* 12. In which area of the city do you work?