Professional Documents
Culture Documents
S.No: Date:
GENERAL INFORMATION
Already educated:
Adults __________ Kids ___________
Being educated:
Adults __________ Kids ___________
Same Separate
______________________________________
____________________________________________________________________________
Yes No
15. Which newspapers are read in the household? Who reads newspapers in the house?
Newspapers: __________________________________
People: __________________________________
Computer _______________
Others _______________________________________________________
____________________________________________________________________
FABRIC CARE
Soap: ________________________________________________________________
Detergent: _______________________________________________________________
Hand: __________________________________________________
Machine: __________________________________________________
Hand: __________________________________________________
Machine: __________________________________________________
________________________________________________________________________
14. Are clothes removed half way through a wash cycle to scrub: Yes No
18. (For joint family ask): Is soap bought individually for each family or one for the whole household?
Separate One
_______________________, _______________________.
Why: ____________________________
23. How are clothes washed in house: (Observe if possible or record verbatim if possible):
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
27. (If softener not mentioned): Aware of any product to soften clothes?
Yes No
28. (If yes): What is such a product called? Could you please name the product?
_____________________________________________________________________________
Machine Bucket
33. No. of clothes Softener was used for ________________ Quantity used for these clothes _____
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
36. Any difference felt in clothes after treating with Softlan? If so, what was it?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
38. Apart from clothes she used Softener for, what other clothes does she think it is suitable for?
_______________________________________________________________________________
_______________________________________________________________________________
Yes No
41. If Yes: Could you please describe the ad as you remember seeing it
______________________________________________________________________________
________________________________________________________________________________
PERSONAL CARE
___________________________________________________________________________
___________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
9. How often do members of their household bathe (prompt with different time frames)
___________________________________________________________________________
11. Do they think that having a separate soap for face washing and bathing is essential?
Yes No
12. Apart from soap what else do they use for personal care?
___________________________________________________________________________
___________________________________________________________________________
_________________________________________
14. (For joint family ask): Is soap bought individually for each family or one for the whole household?
Separate One
_______________________, _______________________.
Why: ____________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
ORAL CARE
One Separately
Powder: __________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
11. Solutions to these problems:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
13. Does she purchase a brand with reference to someone’s Oral Care problems or just one for family
catering to everyone’s problems?
________________________________________________________________________
________________________________________________________________________
Toothpaste: ________________________________________________________
Powder: ________________________________________________________
27. (For joint family ask): Is your toothpaste bought individually for each family or one for the whole
household?
Separate One
Is your toothbrush bought individually for each family or one for the whole household?
Separate One
_______________________, _______________________.
Why: ____________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
33. Where are their toothpastes and toothbrushes kept & how (Observe):
_____________________________________________________________________
_____________________________________________________________________
SURFACE CARE
1. Dishwashing products aware of:
___________________________________________________________________
___________________________________________________________________
Bars: ___________________________________________________________________
___________________________________________________________________
Powders: ___________________________________________________________________
___________________________________________________________________
Liquids: ___________________________________________________________________
___________________________________________________________________
Others: ___________________________________________________________________
Bars: ___________________________________________________________________
Powders: ___________________________________________________________________
Liquids: ___________________________________________________________________
Others: ___________________________________________________________________
________________________________________________________________________
Together Alternatively
___________________________________________________________________________
___________________________________________________________________________
______________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
13. How do they clean food stuck between the prongs in a fork?
___________________________________________________________________________
___________________________________________________________________________
____________________________________________________________________________
___________________________________________________________________________
________________________________________________________________________
18. What kind of dishes do they have for everyday use: ____________________________
___________________________________________________________________________
__________________________________________________________________________
___________________________________________________________________________
27. (For joint family ask): Is a dishwashing product bought individually for each family or one for the
whole household?
Separate One
_______________________, _______________________.
Why: ____________________________
32. Observe dishwashing is possible or record verbatim:
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
TEA
What is your current brand of tea?
If more than one brand: Do you use both brands separately or mix them together?
If using more than one brand and separately: Which tea is used on what occasion?
Does everyone drink the same number of cups or different people drink more or less tea?
Do you use tea bags or have you ever used tea bags?
Yes No
If you go your regular store and your brand of tea is not available. What would you do in such a
situation?
Name: ______________________________________________________
Address: ______________________________________________________
______________________________________________________
______________________________________________________