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Ayr Saline Nasal Rinse Kit User Survey
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Do you use the
Ayr
®
Saline Nasal Rinse Kit
?
Let us know what you think.
1a. Sex:
F
emale
M
ale
1b. Age:
2. In what type of store do you buy the Ayr Saline Nasal Rinse Kit?
Check all that apply.
F
ood
D
rug
M
ass
O
nline
O
ther (see 2a)
2a. If "Other", please specify:
3. For whom do you purchase the Ayr Saline Nasal Rinse Kit?
S
elf
S
pouse
C
hild
O
ther (see 3a)
3a. If "Other", please specify:
4. How did you first learn about the Ayr Saline Nasal Rinse Kit?
D
octor or Pharmacist
I
nternet
C
oupon
I
n store
N
ewspaper or Magazine
R
adio
F
riend or Family
T
elevision
O
ther (see 4a)
4a. If "Other", please specify:
5. How long have you been using the Ayr Saline Nasal Rinse Kit?
L
ess than 6 months
6
months to 1 year
1
to 2 years
2
years or more
6. How often do you use the Ayr Saline Nasal Rinse Kit?
D
aily
1
-3 times a week
3
-6 times a week
O
ccasionally
7. What problems do you use the Ayr Saline Nasal Rinse Kit for?
Check all that apply.
A
llergies
P
ostnasal Drip
S
inusitis
R
hinitis
P
ostoperative Care
C
ongestion
U
se as part of wellness routine
O
ther (see 7a)
7a. If "Other", please specify:
8. How satisfied are you with the Ayr Saline Nasal Rinse Kit?
V
ery satisfied
S
omewhat satisfied
S
omewhat dissatisfied
V
ery dissatisfied
8a. Please explain your response to Question 8.
9. Did you find the instructional pamphlet included in the Ayr Saline Nasal Rinse Kit easy to understand?
Y
es
N
o (see 9a)
9a. If "No", please explain:
10. Did you find the Ayr Saline Nasal Rinse Kit packaging accessible and convenient to open?
Y
es
N
o (see 10a)
10a. If "No", please explain:
11. What do you like most about the Ayr Saline Nasal Rinse Kit?
12. How would you improve the Ayr Saline Nasal Rinse Kit?
13. What brand(s) or product(s) other than the Ayr Saline Nasal Rinse Kit have you used to irrigate your sinuses?
14. How does the Ayr Saline Nasal Rinse Kit compare with the other brand(s) or product(s) you have used?
15. Can you think of any additional improvements that should be made to the Ayr Saline Nasal Rinse Kit?
Enter the letters or numbers as shown.
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© 2010 B.F. Ascher and Company, Inc.
Ayr Saline Nasal Rinse Kit User Survey 
