Ideas For A Clean Break

Survey

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Phone 1
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Household Questionaire

1. What percent of household cleaning would you estimate is done by:

You Household members (spouse, children, etc.) Outside help (hired or volunteer) 100% Total

2. I am:

Single with children at home Married with children at home Single, no children at home Married, no children at home Other

3. Please place in order six cleaning tasks, with "1" being the most-dreaded and "6" being least-dreaded.

Windows Cleaning bathrooms (shower/toilet) Vacuuming Picking up clutter Doing dishes Other

4. My biggest personal fitness challenge (check all that apply)

My weight Too little excercise Lack of regular, good nutrition Problems incident to age Problems due to a health condition(s) None or other

5. I work for money?

No At home Outside the home Retired

6. Money is:

A great stress in my life A moderate stress in my life Little or no stress in my life

7. Most of the time, I feel my household is:

Immaculate Reasonably neat Very cluttered or dirty

If I could change one thing in my life, it would be...

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