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Dallas By Definition is a research firm in Las Colinas, Texas, with convenient offices in the heart of the DFW Metroplex area. Most focus interviews will be held at our local offices. If you are unable to travel to our location to
participate, we will still consider you for phone-based studies and online discussions. |
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All questions marked with an asterisk (*) are required |
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Demographic Information |
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*Date of Birth |
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*What is the highest level of education that you have completed? |
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*How would you describe your ethnic background? |
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*How would you describe your relationship status? |
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*Are you bilingual? |
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What is your religious affiliation? |
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*Are you a registered voter? |
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What is your party affiliation? |
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Work Information |
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*What is your employment status? |
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Company Name: |
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Job Title: |
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Number of Employees (Local): |
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Number of Employees (Worldwide): |
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Household Information |
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*Home Address |
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Apartment or Suite # (if applicable) |
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*City |
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*State |
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*Postal Code |
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*What is your current residence situation? |
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*Residence Type: |
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Is anyone in the household affected by the following conditions? (Select all that apply. Scroll down to see additional selections.)
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Does anyone in the household take prescription medications? |
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What names/brands of medication? |
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What company provides your local telephone service? |
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What company provides your long distance telephone service? |
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Do you have a computer at home? |
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Which computer brand/s do you own? (Select all that apply. Scroll down to see additional selections.)
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What type/s of computer do you own?
(Select all that apply.)
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What company provides your internet service? |
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Do you use any of the following products/services?
(Select all that apply.) |
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Do you own any of the following recreational vehicles?
(Select all that apply.)
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Does anyone in your household participate in the following sports/activities? (Select all that apply. Scroll down to see additional selections.) |
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Does anyone in your household travel by air in a typical year? |
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How many times does your household travel by air each year? |
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How would you classify this air travel? |
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Which airline/s do you use regularly? (Select all that apply. Scroll down to see additional selections.)
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Do you currently have any pets in the household? |
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What type of pets? (Select all that apply. Scroll down to see additional selections.) |
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*Into what range does your annual household income fall? (before taxes)? |
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*Do you have children living in the household? |
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Child 1 First Name
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Birthdate
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Gender
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Child 2 First Name
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Birthdate
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Gender
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Child 3 First Name
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Birthdate
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Gender
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Child 4 First Name
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Birthdate
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Gender
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Child 5 First Name
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Birthdate
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Gender
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Child 6 First Name
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Birthdate
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Gender
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Do you have a vehicle? |
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Vehicle Information |
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What vehicles are driven in the household and how were they purchased? |
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Vehicle 1 Make:
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Model:
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Year:
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How Acquired:
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Vehicle 2 Make:
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Model:
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Year:
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How Acquired:
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Vehicle 3 Make:
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Model:
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Year:
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How Acquired:
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Vehicle 4 Make:
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Model:
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Year:
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How Acquired:
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What type of car insurance do you carry? |
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Products and Preferences |
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Who is your cell phone service provider? (if applicable) |
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Is your phone a Smartphone? |
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What brand of cell phone do you own? |
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What is your cell phone model? |
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Do you regularly use any of the following tobacco products? |
Cigarettes - Regular |
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Cigarettes - Menthol |
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Cigars |
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Chewing Tobacco |
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No Tobacco Products |
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What cigarette brands do you use on a regular basis? (Select all that apply. Scroll down to see additional selections.) |
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Do you drink wine? |
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What types of wine do you drink regularly? |
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What brands/vineyards do you regularly enjoy? |
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Do you drink beer? |
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What brands do you drink regularly?
(Select all that apply. Scroll down to see additional selections.) |
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Do you use any corrective lenses? |
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Have you had any kind of vision correction surgery, such as Lasik? |
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What kind of razor products do you use regularly? |
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Which kind of razor product do you use most often? |
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Which radio stations do you listen to regularly? (Select all that apply. Scroll down to see additional selections.) |
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