Cosmetics Survey For Women
1. What is your age? ________ years old 2. On average, how much in US dollars would you say you spend on cosmetics products per month? $_____________ 3. Where do you purchase cosmetics products from most of the time? (Please check all that apply.) Drug stores like CVS or Walgreens Cosmetics specialty stores like Sephora Other (please specify): _________________________________________ 4. Of the cosmetics products you purchase, check all the product types below that you have purchased. moisturizer eye creams, moisturizers or serums skin brightening products 5. On a scale of 1 to 5 with 5 being the most and 1 being the least, how much more likely are you to purchase a product if it advertises a new ingredient using nanotechnology to produce better results? Please circle one. 5 Much more likely 4 3 2 1 Not at all more likely nighttime creams skin firming products Grocery stores like Kroger Department stores like Macy’s
6. Have you purchased any cosmetic products in the past that were advertised as “antiaging” products? Circle “yes” or “no.” Philosophy L’Oreal Olay Other (please specify): _________________________________________ 8. What is your approximate gross household income in one year? Please check one. yes no Lumene Patricia Wexler, MD MD Formulations 7. What cosmetics brands do you associate with anti-aging products? Check all that apply.
$15,000 or less $26,000-36,000 $51,000-70,000 $91,000 or more
$16,000-25,000 $37,000-50,000 $71,000-90,000
9. What is your occupation? _________________________________