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Hello:
You are invited to participate in our survey [Project Description Here]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [Approximate Time] minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.

Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
How old are you?
 
18-25
 
25-40
 
40-65
 
65+
 
I do not wish to answer this question
 
 
 
How would you describe the area that you live in?
 
The city
 
The greater city area (suburbs)
 
A rural area
 
I do not wish to answer this question
 
 
 
What is your average household income? (per year)
 
<$20,000
 
$20,000-$40,000
 
$40,000-$80,000
 
$80,000+
 
I do not wish to answer this question
 
 
 
How many persons live in your household?
 
I live alone
 
2
 
3-4
 
5+
 
I do not wish to answer this question
 
 
 
How many children do you have (under the age of 18)?
 
None
 
1
 
2
 
3-4
 
5+
 
I do not wish to answer this question
 
 
 
Do you have any pets?
 
Yes - One
 
Yes - Two
 
Yes - Three +
 
No
 
I do not wish to answer this question
 
 
 
How many people in your household work?
 
I live alone
 
Only I work (but live with others)
 
Some of the people I live with work
 
All of the people I live with work
 
None of the people I live with work (nor do I)
 
I do not wish to answer this question
 
 
 
How many hours do you work per week on average?
 
<10
 
10-25
 
25-40
 
40+
 
I do not wish to answer this question
 
 
 
If could afford it right now (money was not an issue), would you like to hire someone for cleaning services? (ie. Indoors - housekeeping)
 
Yes
 
No
 
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