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Surveys
2012
March
A
A Day in your Life
A Day in your Life
0%
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What is your Age?
18-22
23-30
31-40
41-50
51-60
61+
What is your ethnicity?
American Indian
Black or African American
Asian
White
Hispanic or Latino
Other
Do you have any physical limitations (select all that apply)?
I do not have any limitations
Vision
Hearing
Mobility with use of aids (for example: wheel chair, crutches, or canes)
Mobility but so not require the use of aids (for example: limited mobility in legs, arms, or neck)
Other-please describe
Do you depend on another person to assist you in your daily life?
Yes
No
What is your marrital status?
Single
Married
Divorsed
Widowed
How many kids do you have?
0
1-2
3-4
5-6
7+
What is your employment status?
Umemployed
Employed but work from home
Employed and work outside of the house
Homemaker
Describe your Morning routine. (for eaxample: read the paper, hours spent talking or texting, hours of TV watched, Drive time in car and commonly visited locations) Please be as detailed as possible.
Describe your afternoon routine. (for eaxample: read the paper, hours spent talking or texting, hours of TV watched, Drive time in car and commonly visited locations) Please be as detailed as possible.
Describe your Evening routine. (for eaxample: read the paper, hours spent talking or texting, hours of TV watched, Drive time in car and commonly visited locations) Please be as detailed as possible.
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