Fiber Survey
We would appreciate 5 minutes of your time to answer a few questions below. Thank you in advance!
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1.a. Name (optional)
1.b. Age *
1.c. Gender *
1.d. Marital Status *
1.e. Occupation *
1.f. Highest Educational Attainment: *
1.g. What do you do on your spare time? *
Please check all that applies:
Required
2.a. From which sources do you get the fiber needed by your body?
2.a.i. Cite examples and reasons for using the items that you checked above.
3.a. Are you aware of any of these fiber supplements?
Yes
No
Fiber in yogurt such as Nestle’s Acti-V Yogurt
Fiber in a ready-to-drink product such as Oishi’s Fiber and Fruit Juice Drink
Fiber in a sachet/powder form such as Fibrosine and Cillium
Fiber in a capsule
Others (please specify below)
Clear selection
3.a.i. Please specify other products that were not mentioned above
3.b. Which of these have you tried?
Tried
No/ not yet
Fiber in yogurt such as Nestle’s Acti-V Yogurt
Fiber in a ready-to-drink product such as Oishi’s Fiber and Fruit Juice Drink
Fiber in a sachet/powder form such as Fibrosine and Cillium
Fiber in a capsule
Others (please specify below)
Clear selection
3.b.i. Please specify other products that were not mentioned above
3.c. Which of these are you currently taking?
Taking
Not taking
Fiber in yogurt such as Nestle’s Acti-V Yogurt
Fiber in a ready-to-drink product such as Oishi’s Fiber and Fruit Juice Drink
Fiber in a sachet/powder form such as Fibrosine and Cillium
Fiber in a capsule
Others (please specify below)
Clear selection
3.c.i. Please specify other products that were not mentioned above
3.d. Where do you usually buy the product/s?
4. In your opinion, what is the end-benefit of using fiber supplements? Please rank the following by choosing one number from the drop down list.  Rank 1 means most important.
Example:
For medical/ health reasons
1
To maintain or improve over-all physique
3
To have control over my bowel
2
For medical/health reasons (ie to maintain a healthy colon and avoid sickness like diabetes, cancer, heart diseases)
To maintain or improve over-all physique/wellness reasons (ie to look and feel good/light/slim, help in weight loss)
To have control over my bowel movement (ie healthy and regular bowel movement every day)
Others: please specify below. .
Please specify here other benefits of using fiber supplements
5. How much are you willing to pay for a fiber supplement?
Clear selection
6. If at the right price, how often would you be willing to take in the fiber supplement?
Clear selection
7. What is your preferred fiber supplement format:
8. For a fiber supplement, please rank the following based on order of importance to you. Please rank the following by choosing one number from the dropdown list. Rank 1 means most important
Example:
Taste
1
Efficacy/ Speed of action
3
Price
2
Packaging format
4
Taste
Efficacy / Speed of action
Price
Packaging format
Others: (please specify below)
Please specify here other factors you consider in using fiber supplements
9. If you are not taking a fiber supplement, why not?
i
10. What would make you take a fiber supplement?
Please let us know who referred you to answer this survey. *
Thank you very much!
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