FocusJr

Name

Telephone number

Address

City

State

Zip code

Email address

What is your job title or position?

What is your age:

When was the last time that you, yourself, participated in a marketing research study? Would that be…?

In the past 6 months
6-12 months ago
More than 12 months ago
Never

Are you currently scheduled to participate in any marketing research studies at or any other company, or not?

Yes
No

What is your current employment status? Are you….?

A full-time employee
Working part-time
A stay-at-home parent
Retired
Student
Laid-off / looking for work

Where are all the working members of your household, including yourself, currently employed, previously employed, or retired from? Any others?

Are you or is any member of your household currently employed by, previously employed by, or retired from any of the following types of companies?

An advertising agency or graphic design firm
A market research firm or marketing department within your own firm
A public relations company
A radio or TV broadcasting station, a newspaper or magazine publishing company
A company that manufactures, distributes, or sells eye care products such as contacts, solutions, eye glasses, etc
Owner, partner or employee of a vision care office or store

Do you, yourself, wear or use any of the following?

Asthma inhaler
Prescription eye glasses
Non-prescription eye glasses
Soft contact lenses
Contact lenses with a handling tint
Colored contact lenses that are specifically designed to enhance or change the color of your eyes
Prescription sunglasses
Non-prescription sunglasses
None of the above

FOR PRESCRIPTION EYEGLASS WEARERS ONLY, OTHERS SKIP THIS QUESTION. Where did you purchase your current Prescription eye glasses??

Local Optician
Costco
Vision Source
Luxottica Retail
Wal-mart Stores
National Vision
Visionworks
MyEyeDr.
Refac Optical Group
Eyecare Partners
Eyemart Express
LenCrafters
Other
I do not wear prescription eyeglasses

FOR THOSE THAT USE SOFT CONTACT LENSES ONLY, NON USERS SKIP THIS QUESTION: You mentioned that you wear soft contact lenses, how long have you been wearing them? _______ # of Years ______ # of Months

FOR THOSE THAT USE SOFT CONTACT LENSES ONLY, NON USERS SKIP THIS QUESTION: How many days a week do you wear soft contact lenses?

Please tell me to what degree you, yourself, participate in shopping for your household’s eye care products. Would you say you…

Almost always purchase eye care products for the household
Share about equally the responsibility for purchasing eye care products for the household
Sometimes purchase eye care products for the household
Rarely or never purchase eye care products for the household

FOR THOSE THAT USE SOFT CONTACT LENSES ONLY, NON USERS SKIP THIS QUESTION: Within the past six months, which of the following brands of contact lens care products, have you, yourself purchased?

Acuvue Oasys (2week)
Acuvue Vita
Acuvue 1Day Moist
Air Optix Aqua
Biofinity
BioTrue 1Day
B&L SofLens
B&L Ultra
Clariti 1Day
CooperVision 1Day
Dailies Aqua Comfort Plus
Dailies Total 1
Freshlook Colors
Hubble
02 Optix
Proclear 1 Day Contact Lenses
Other:

FOR THOSE THAT USE SOFT CONTACT LENSES ONLY, NON USERS SKIP THIS QUESTION: Thinking now of where or how you typically purchase your contact lens products. In the past 6 months, where have you purchased your lens care products?

Online via internet
Store or Shopping Channel
Grocery store
Drug store
Mass Merchandiser
Club Store
Other
I do not use contact lens

FOR THOSE THAT USE SOFT CONTACT LENSES ONLY, NON USERS SKIP THIS QUESTION: You mentioned that you purchased your lenses online. Can you tell me a little more about the process in terms of how far in advance you need to order and the quantity you typically order?

In order to represent all groups equally, which of the following best describes your ethnic background? Would you say…?

African-American
Asian
Caucasian
Hispanic/Latino
Native American
Bi-racial
Other

What level of education have you, yourself, completed?

Attended high school, but did not graduate
High school graduate
Completed some college
Graduate of a 2 - year college
Graduate of a 4 - year college
Post graduate/study/degree
Other

Which of the following best describes your total annual household income before taxes?

Less than $35,000
$35,001 – 39,999
$40,000 – 49,999
$50,000 – 59,999
$60,000 – 69,999
$70,000 – 79,999
$80,000 – 89,999
$90,000 – 99,999
$100,000 or more

Now I’m going to read you a series of statements on a scale of 1 to 10 and I’d like to have you tell me how well they express your feelings. A score of 10 means the statement describes your feelings extremely well and a score of 1 means the statement does not describe your feelings at all, and you can use any number in between.

If asked to describe something, I can usually do so in detail

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I’m comfortable expressing my feelings in a group

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My friends often ask my opinions of things

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I generally have an opinion or point-of-view on topics or issues

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I enjoy exchanging ideas with people on a wide variety of things

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People tell me I’m creative

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Submit Your Responses