Project Heat

Market Research

We are looking for males and females aged 35 to 59 to take part in a discussion for 1 hour in Central London about Heartburn. Please note that the first part of this discussion will last for 1 hour. You may be selected during the discussion to participate for a further 90 minutes. Please ensure that you are available and willing to stay for the full 2.5 hours before applying for this study.

Please answer the questions below.

Name:

Telephone Number:

Postcode:

Age:

Occupation:

Highest level of education achieved:

Is your household income above or below £20k?

Marital status i.e. married, cohab, single, divorced, etc...

Who do you live with in your household? If you have children, please tell us their ages.

Please tell us if you suffer from any of the following regularly; Heartburn, Acid Reflux or Acid Indigestion?

How often do you suffer with symptoms?

How long have you been suffering with these symptoms?

Please tell us if your symptoms affect any of the following; A) what you eat and drink? B) your sleeping pattern?, C) Is your condition predictable or unpredictable i.e. never know when it will happen?

Please tell us if you use over the counter medications or prescription medications for your symptoms

Please list the name/s of the medication/s that you use and buy to treat your symptoms i.e. Alka Seltzer, Rennie, Gaviscon, Milk of Magnesia, Omeprazole, Pepcid Two, Zantac, etc...

Please tell us if how satisfied you are currently with your medication and whether you feel your symptoms are under control.