Radio Campaign Questionnaire

Welcome! We appreciate your participation in our online questionnaire and ask that you answer each question thoroughly, with as much detail as possible. Your feedback will help us include your station in our planning and afford us valuable information for our clients that only local radio stations can provide.

We are currently working with a client that manufactures a supplement with a variety of health and wellness benefits. We're looking for on-air personalities who are willing to take the supplement daily and report on results to their listeners.

WHAT WE NEED: On-air personalities who have specific health and wellness concerns that can be addressed by our client’s product.


Separate each daypart with commas
Separate each daypart with commas
2. Are any of the following health and wellbeing issues of concern to you? (check all that apply):
5. Please indicate whether you have been diagnosed with any of the following health conditions (check all that apply):
6. Please indicate which of these prescription medications, if any, you are currently taking (check all that apply):