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| Are you a male or female? |
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| Please Write in what state you are currently residing in _____________ |
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| What is your net income for your household? |
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| How interested are you in a climate controlled insole? |
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| Do you suffer from sweaty feet from shoes after extensive use? |
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| How often do you buy insoles? |
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| Do you find a need for more arch support in your shoes? |
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| What would be a good name for this product? |
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| Would you be willing to buy this product? |
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