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Questions marked with an * are required
 
 
* Name
   
* Phone
   
 
 
 
* Gender
 
Male
 
Female
 
 
 
* Age
 
Below 25
 
25-35
 
36-45
 
46-60
 
Above 60
 
 
 
* Household Income(RMB)
 
Below 8000
 
8000-10000
 
10000-12000
 
12000-15000
 
15000-20000
 
Above 20000
 
 
 
* Without regard to consumption in restaurants or any other food service occasions, what type of hot beverages do you most often drink at home or at office?
 
Tea
 
Coffee
 
Cereal drink (walnut powder, soy milk, etc)
 
Drinking Chocolate
 
Milk tea
 
Other (Specify)
 

 
 
 
* Thinking about cereal drink, on average how many cups would you drink at home or at office in a normal day?
 
2 plus a day
 
1 to 2 a day
 
4 to 6 a week
 
1 to 3 a week
 
Less
 
Never
 
 
 
* Thinking about coffee, on average how many cups would you drink at home or at office in a normal day?
 
2 plus a day
 
1 to 2 a day
 
4 to 6 a week
 
1 to 3 a week
 
Less
 
 
 
* And what type of coffee did you drink at home or at office in the last month?
 
Instant black
 
Instant regular 2 in 1
 
Instant regular 3 in 1
 
Instant decaffeinated
 
Instant cappuccino/mocha/late/other
 
Brewed coffee plunger/espresso machine/Nespresso/etc
 
Other (Specify)
 

 
 
 
* Which type of coffee do you mostly drink at home or at office?
 
Instant black
 
Instant regular 2 in 1
 
Instant regular 3 in 1
 
Instant decaffeinated
 
Instant cappuccino/mocha/late/other
 
Brewed coffee plunger/espresso machine/Nespresso/etc
 
Other (Specify)
 
 
 
 
* You mentioned instant coffee, which format do you drink at home or at office?
 
black instant, and you add sugar or milk into it
 
black instant without sugar and milk
 
regular instant 2 in 1
 
regular instant 3 in 1
 
decaffeinated instant with or without sugar or milk
 
Instant cappuccino/mocha/late/other
 
Other, specify
 

 
 
 
* Which format of instant coffee do you drink the most often at home or at office?
 
black instant, and you add sugar or milk into it
 
black instant without sugar and milk
 
regular instant 2 in 1
 
regular instant 3 in 1
 
decaffeinated instant with or without sugar or milk
 
Instant cappuccino/mocha/late/other
 
Other, specify
 
 
 
 
And finally, I’d like to ask you some brief questions about health.
 
 
 
* Have you heard of the disease called Nail Fungus?
 
Yes
 
No
 
 
 
* Have you ever suffered from Nail Fungus?
 
Yes
 
No
 
 
 
* What treatment did you or your friends/relatives use?
 
Liang jia
 
Loceryl
 
Iodine
 
Traditional Chinese medicine
 
Did not have treatment
 
Other (specify)
 

 
 
 
* And when you last suffered from Nail Fungus who did you consult for treatment?
 
A doctor
 
A Traditional Medicine Practitioner
 
A pharmacist
 
Friends or relatives
 
The internet
 
I self-medicated
 
No one, I just ignored it

 
 
 
* Nail Fungus is characterized by the nail becoming ridge and brittle. The nail gradually becomes discolored, thickened and cracks or flakes. The infected nail can fall off if it is not treated, have you ever had those symptoms?
 
Yes
 
No
 
 
 
* What treatment did you or your friends/relatives use?
 
Liang jia
 
Loceryl
 
Iodine
 
Traditional Chinese medicine
 
Did not have treatment
 
Other (specify)
 

 
 
 
* And when you last suffered from Nail Fungus who did you consult for treatment?
 
A doctor
 
A Traditional Medicine Practitioner
 
A pharmacist
 
Friends or relatives
 
The internet
 
I self-medicated
 
No one, I just ignored it