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SURVEY QUESTIONNAIRE

Name: ____________________________________
Age: _____
Questions:

1. What can you say about your life having an air pollution?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
2. Do you have any idea to keep your health far from any viruses coming from the air?
______________________________________________________________________________
______________________________________________________________________________
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3. Is it okay for you to have this mask as a protection for you and your family?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

-It filters particles from bad bacteria to


fine particles.
-allows to breathe comfortably
-doesn’t generate moisture while exhaling
-its unique design allows your face to be
visible

4. Is the design will be comfortable for you to wear it? If not, can you suggest any recommendation
about the design?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
5. What should be the amount of the product considering its quality? According to your
recommended design?
o 200-300
o 300-400
o 500
o Others (Please specify) ________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

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SIGNATURE

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