Help with General Interest Survey wording

[TwinMomPlus]

I was thinking of posting some general interest surverys around town (like in small shops such as our natural foods store) to see if there is any interest for a local cloth diapering store. I was wondering if you ladies had any suggestions for the format or the wording. I was thinking of something simple like where they can simply check yes or no, and also include their email if they are interested in me following up. What do you think? Any ideas? I am calling around to see if there are any CD stores in Delaware (none that I know of but you never know) and everyone keeps telling me to go to Walmart!! Argh!

[Austin'smom]

Good idea. You could also see if there are any more holistic peds in the area that wouldn't mind you posting the survey in the lobby. Mine has a list of local cloth diaper suppliers along with other things.