Free Coupon Survey

In order to help us provide the best Orajel products we can, please take a few minutes to complete the following survey. Your time is appreciated and we will thank you by sending you coupons for your favorite Orajel products. Please allow 4 weeks for processing.

Please enter your personal information:
* First Name:	Please enter your first name.
* Last Name:	Please enter your last name.
* Address:	Please enter your address.
* City:	Please enter your city.
* State:	Please enter your state.
* Country:	Please enter your country.
* Zip:	Please enter your zip.
* Age:	15 and Under 16 to 25 26 to 35 36 to 45 45 to 55 55 and Above
* Sex:	Male
	Female
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* Email:	Please enter your Email Address.
1.) Prior to accessing this Web Site, which Orajel products were you aware of? (Check all that apply.)
Baby Orajel Teething Pain Medicine Orajel for Toothache Pain Orajel Denture Plus Orajel Perioseptic Orajel Toddler Training Toothpaste None Orajel Mouth Sore Medicine Orajel Ultra Canker Sore Medicine Orajel Multi-Action Cold Sore Medicine Orajel Sensitive Baby Orajel Tooth & Gum Cleanser Orajel Kids Sore Throat Strips
2.) Have you ever purchased or used an Orajel product? (If NO, please go to question 9)
Yes No
3.) If yes, which products have you purchased or used?
Orajel for Toothache Pain Orajel Denture Plus Baby Orajel Tooth & Gum Cleanser Orajel Perioseptic Baby Orajel Teething Pain Medicine None Orajel Mouth Sore Medicine Orajel Ultra Canker Sore Medicine Orajel Multi-Action Cold Sore Medicine Orajel Sensitive Orajel Toddler Training Toothpaste Orajel Kids Sore Throat Strips
4.) What influenced you to buy an Orajel product? (Check all that apply.)
Advertising Package Claims Pharmacist, Dentist, Doctor Friend Received Sample or Coupon Other
5.) Who actually made the purchase?
I purchased. Husband/wife purchased it. Relative/friend gave it to me.
6.) How satisfied are you with the Orajel products you have purchased?
Very Satisfied Somewhat Satisfied Somewhat Dissatisfied Very Dissatisfied
7.) Why?
8.) What other brands have you used prior to or since you bought that Orajel product? (if any skip question 9).
9.) Why haven't you purchased an Orajel product? (Check all that apply.)
Not aware of specific Orajel products and their benefits Have not had a need for any of the products Preferred a competitive brand Price too high
10.) Based on the information you just read on-line would you be likely to buy any of our Orajel products in the future? (If so, which would you try?)
Orajel Mouth Sore Medicine Baby Orajel Teething Pain Medicine Orajel Denture Baby Orajel Tooth & Gum Cleanser Orajel Perioseptic Orajel for Toothache Pain None Orajel Ultra Canker Sore Medicine Orajel Multi-Action Cold Sore Medicine Orajel Sensitive Orajel Toddler Training Toothpaste Orajel Kids Sore Throat Strips
11.) Before accessing the Orajel web site - please tell us your top of mind impressions of Orajel?
12.) Which descriptions best reflect your impression of Orajel? (Check all that apply.)
High quality products Brand you can trust Products for the mouth Provides pain relief Good value Haven't tried Other
13.) How did you learn about our website?
Print Advertising TV Advertising Packaging Subject search Hypertext Word of mouth Doctor/Dentist/Pharmacist Other
14.) Did you access the site from:
Home School Work Other
15.) How helpful/interesting did you find the site?
Very helpful/interesting Somewhat helpful/interesting Not helpful/interesting at all
16.) Would you like to receive occasional email updates about news and new Orajel products?
Yes No
17.) If you chose Yes to receive email updates, please indicate which products you are most interested in:
Orajel Adult Orajel Toddler Baby Orajel Orajel Kids Sore Throat