Dear respondents,

Good Day! We are the students of BSBAMA3A from Centro Escolar University conducting a study about the
feasibility of lozenges made from shiitake mushroom extracts. As a part of our requirement in Fundamentals of Research,
we are asking for your cooperation in answering the following questions. Kindly answer them as truthful as possible.
Rest assured that your answers will be strictly confidential. Thank you and God bless!
Very yours truly,
The Researchers
Checked by: Approved for distribution:

Mr. Edgar Tichepco Dr. Ma. Flordeliza L. Anastacio

Business Adviser Dean, School of Accountancy and Management
A. Please supply the information asked for.
Gender: __Male __Female
Age: ______ Sex: ____ Brgy #:______
Student __working __non-working
How much is your monthly allowance/income?
□ Php500 below □ Php5001-10,000
□ Php501-2000 □ Php10,001-15,000
□ Php2001-5000 □ Php15,001 above

B. Please put a check before the chosen option.

1. How often do you experience throat □ Others, pls specify:
problems (average/month)? _____________
□ Once a month
□ 2-3 times a month 6. Have you heard of shiitake mushroom?
□ Weekly □ Yes
□ Occasionally □ No
□ Never 7. Would you consider to buy shiitake
2. Have you heard of lozenges? mushroom lozenges?
□ Yes □ Yes
□ No □ No
3. Where did you learn about lozenges? 8. What factor mostly affects your choice in
□ Brochures/Leaflets brand of lozenge to buy?
□ Magazines/Books □ Availability
□ Doctors/Physicians □ Effectiveness
□ TV/Commercials □ Packaging
□ Others:____________________ □ Price
4. What brands of lozenges are familiar to □ Others, pls. specify ________
you? (you may choose more than 1) 9. Where do you usually buy them?
□ Halls □ Convenience Stores
□ Strepsils □ Drug Stores
□ Xylitol □ Groceries
□ Others, pls. □ Sari-Sari Stores
specify:______________ □ Others (pls. specify): _______
5. What flavors of lozenge do you like 10. How much are you willing to pay for a
most? lozenge? (per piece)
□ Apple □ Php3.00 – Php 5.00
□ Honey □ Php5.01 – Php8.00
□ Mint □ Php8.01 – Php10.00
□ Orange □ Php10.01 or higher
□ Plain mentholated
 11. What is your preference regarding the
packaging?
□ Individually
□ By 6’s
□ By 12’s
Thank you for answering. God bless! ☺