Adult Non-Windows Users

Attention Non-Windows Users:

We apologize that our coupon printing software does not support your operating system at this time. As an alternative offer, we will send you via mail a $2.00 coupon plus a trial size of Extra Strength TYLENOL* Cold if you complete the following form below."

Your Contact Information

* indicates a required field.

*	Preferred Title:	Mr. Ms. Mrs. Miss
*	First Name:
*	Last Name:
*	Age:
*	Address:

*	City:
*	Province:
*	Postal Code:
*	Daytime Phone Number:	()
*	E-Mail

Please answer the following questions as accurately as possible. There are no wrong answers.

1.	What brand of pain reliever do you consider to be your main brand, that is, the one you use most often?

How often do you use the following pain medication? (Check as many as apply:)

	Daily	Weekly	Monthly	Infrequently
TYLENOL* Extra Strength
TYLENOL* Regular Strength
Advil
Aspirin
Motrin
Store Brand
Other

3.	What causes your headaches? (Max. 5 lines)

Whose advice, if any do you seek when choosing a pain reliever? (Check as many as apply:)

Doctor	Pharmacist
Friends	Nurse
Parents/Family	Other

From the list below rate how important each factor is to you when deciding what brand of pain reliever to purchase?

	Very Important	Somewhat Important	Depends	Not Important
Strength
Fast Acting
Trusted Brand
Safety
Convenience
Effectiveness
Price
Specific Pain Relief

*6.

Periodically, McNeil Consumer healthcare, on behalf of the Johnson & Johnson family of companies, sends information and special offers to our most valued customers. Would you be interested in receiving these updates?

Yes	No
If yes, contact me via:

* Registered Trademark