FocusJr

Name

Telephone number

Address

City

State

Zip code

Email address

What is your job title or position?

Are you:

Male
Female

Are you or is any member of your household employed by, laid off from or unemployed from, or retired from any of the following types of companies?

a. Advertising agency or public relations firm.
b. News media such as TV, radio, newspaper, magazine.
c. A market research firm or the market research department within a company.
d. A company that sells, manufactures or distributes any type of consumer beverages.
e. A retailer or wholesaler of consumer beverages.

Have you taken part in any market research studies, including attending focus groups or in-home visits, about consumer beverages in the past 12 months?

Yes
No

Have you taken part in any market research studies on any topic in the past 6 months?

Yes
No

What is your current employment status?

Employed full time
Employed part time
Full time student
Stay at home parent
Unemployed – looking for work
Unemployed – not looking for work
Retired

What is your profession?

What is your exact age?

Who makes the food/beverage decisions in your household?

I make the decisions, solely.
I share in the decision making with someone else in my household.
Someone else in my household is the primary decision maker for healthy beverages.

When it comes to healthy beverages which of the following do you consume on a regular basis?

Kombucha
Bottled Green Tea
Bottled Mint Tea
Fresh Fruit Juices (Ex: Orange/Apple/Pomegranate Juice etc…)
Fresh Vegetable Juices (Ex: Carrot/Celery/Beet/Kale/Tomato/Mixed Vegetable.
Bottled Fresh Fruit Juice
Bottled Vegetable Juice
Coconut Water
Lemon Juice
Ginger Tea
Cranberry Juice
Filtered or Bottled Water
Soy Milk
Fat free milk

If you drink Kombucha, Coconut Water, Bottled Fruit Juice, Bottled Vegetable Juice, Bottled Green or Mint Tea, please tell me your favorite brand for each beverage. One brand per beverage, If you do not drink a beverage that write in "do not drink"..

Kombucha

Coconut Water

Bottled Fruit Juice

Bottled Vegetable Juice

Bottled Green or Mint Tea

Now I’m going to read you 4 statements, please tell me how much you agree or disagree with each statement.

I read product labels regularly

Agree Strongly
Agree
Neither Agree nor Disagree
Disagree
Disagree Strongly

I maintain a healthy/active lifestyle

Agree Strongly
Agree
Neither Agree nor Disagree
Disagree
Disagree Strongly

I consider myself to be health conscious

Agree Strongly
Agree
Neither Agree nor Disagree
Disagree
Disagree Strongly

I make a conscious decision to buy products that are natural or organic

Agree Strongly
Agree
Neither Agree nor Disagree
Disagree
Disagree Strongly

Are there any health drinks that you would never consider purchasing?

Kombucha
Coconut Water
Bottled Fruit Juice
Bottled Vegetable Juice
Bottled Green or Mint Tea

How many times a month do you drink your favorite brands (Ex: 1x per week, 2x week, 3x week etc…? If you do not drink a certain beverage LEAVE BLANK.

Kombucha

Coconut Water

Bottled Fruit Juice

Bottled Vegetable Juice

Bottled Green or Mint Tea

What is your favorite brand for the following healthy beverages? Please name BRAND.

Kombucha

Coconut Water

Bottled Fruit Juice

Bottled Vegetable Juice

Bottled Green/Mint Tea

What highest level of education have you, yourself, completed?

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

What is your annual household income?

Less than $40K
40K - $64,999
$65K - $74,999
$75K - $99,999
$100K - $149,999
$150K+

Which ethnic group do you most closely identify with?

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

Now I am going to ask you a question that has no right or wrong answer, I would just like to explore your creative side a little more. Imagine you could have dinner with any person either living or not, who would it be and what questions would you ask of them during dinner?

Submit Your Responses