MARKET RESEARCH – Project Chestnut *Revised*

We are looking for children and adults aged 12 – 65+ who have been diagnosed with COPD to take part in an interview for 45 minutes in London about COPD and inhalers.

If you are applying for your child to take part aged 12-15 you will be required to be a chaperone. The chaperone will receive £25.

LOCATION:		London WC1
DATE:		Dates vary between Monday 9th March – Friday 13th March 2015 - TBA
TIME:		Various daytime slots available
INCENTIVE:		£30.00

Please answer the questions below.

Name:

Telephone Number:

Postcode:

Age:

Are you/your child left or right handed?

How long ago were you/your child diagnosed with asthma?

Please tell us the name of the inhaler/s that you/your child uses i.e. Accuhaler, Turbohaler, Diskhaler, Pmdi puffer (blue, brown, red, etc), other dry powder inhaler

If you/your child uses an Accuhaler, please specify if it is one of the following

Seretide Accuhaler
Ventolin Accuhaler
Flixotide Accuhaler
Serevent Accuhaler

Please forward this on to anyone you know who may be interested.

Unfortunately, it is impossible to reply to all emails or phone messages. We receive lots of responses to researches that are emailed out. You will be contacted by phone if your application is successful. However, we apologise if you do not hear from us, but please keep trying for future projects that are sent out.

We look forward to hearing from you.

Kind regards,

Daliah Salem
trend MARKET RESEARCH LTD