Asthma Research

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name of product user (optional)
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sex of product user (optional)
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age of product user (optional)
 Under 18 
 18-24 
 25-34 
 35-44 
 45-54 
 55-64 
 65 or Above 
 Prefer Not to Answer 
product size
 small shoe box: kids 
 medium shoe box: ladies 
 large shoe box: mens 
 x-large shoe box: boots 
 other (fill in comments box at end) 
features
 inhaler holder 
 cream holder 
 drink holder 
 tissue holder 
 night light (comes on when dark) 
 manual light (user switches on) 
 ALARM (sounds in room) 
 ALARM (sounds on remote unit) 
 glow in dark 
 drawer 
 music 
 other (fill in comments box at end) 
If ALARM answered
 wired 
 wireless 
 don't mind 
bed type
 normal 
 cabin 
 bunk 
 other (fill in comments box at end) 
colour
 blue 
 pink 
 red 
 orange 
 yellow 
 green 
 clear 
 black 
 white 
 funky kids 
 rainbow 
 other (fill in comments box at end) 
cost
 up to £10 
 £10 to £15 
 £15 to £20 
 £20 to £30 
 £30 + 
 cheap as possible 
 doesn't matter if product does job 
 other (fill in comments box at end) 
power
 mains 
 battery 
 both 
portable
 yes 
 no 
 don't mind 
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