Developing Brand & Creative Concepts Designed to Prevent AI/AN Youth Tobacco Use

Unique ID:____________

BRAND TEST
SURVEY
Version A

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to
average 5 minutes per response to complete the Brand Test Survey (the time estimated to read, review, and complete). Send
comments regarding this burden estimate or any other aspects of this information collection, including suggestions for
reducing burden, to PRAStaff@fda.hhs.gov.
OMB# 0910-0796 Exp. 07/31/2021

Page 1
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Unique ID:____________

1. Which BRAND NAME do you like the
best? (Circle one response)

A.

[Brand Name 1]

B.

[Brand Name 2]

C.

[Brand Name 3]

OMB# 0910-0796   Exp. 07/31/2021

Page 2
! of 6
!

Unique ID:____________

2. For [Brand Name 1], which LOGO do you
like the best? (Circle one response)

A.

[Brand Name 1, Logo A]

B.

[Brand Name 1, Logo B]

C.

[Brand Name 1, Logo C]

OMB# 0910-0796   Exp. 07/31/2021

Page 3
! of 6
!

Unique ID:____________

3. For [Brand Name 2], which LOGO do you
like the best? (Circle one response)

A.

[Brand Name 2, Logo A]

B.

[Brand Name 2, Logo B]

C.

[Brand Name 2, Logo C]

Page 4
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021

Unique ID:____________

4. For [Brand Name 3], which LOGO do you
like the best? (Circle one response)

A.

[Brand Name 3, Logo A]

B.

[Brand Name 3, Logo B]

C.

[Brand Name 3, Logo C]

Page 5
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021

Unique ID:____________

5. Please choose your OVERALL favorite
logo design. (Circle one response)

[Brand Name
[Brand Name
[Brand Name
A.
B.
C.
1, Logo A]
1, Logo B]
1, Logo C]

D.

[Brand Name
[Brand Name
[Brand Name
E.
F.
2, Logo A]
2, Logo B]
2, Logo C]

G.

[Brand Name
[Brand Name
[Brand Name
H.
I.
3, Logo A]
3, Logo B]
3, Logo C]

Page 6
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021

Unique ID:____________

BRAND TEST
SURVEY
Version B

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to
average 5 minutes per response to complete the Brand Test Survey (the time estimated to read, review, and complete). Send
comments regarding this burden estimate or any other aspects of this information collection, including suggestions for
reducing burden, to PRAStaff@fda.hhs.gov.
OMB# 0910-0796 Exp. 07/31/2021

Page 1
! of 6
!

Unique ID:____________

1. Which BRAND NAME do you like the
best? (Circle one response)

A.

[Brand Name 3]

B.

[Brand Name 2]

C.

[Brand Name 1]

Page 2
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021

Unique ID:____________

2. For [Brand Name 3], which LOGO do you
like the best? (Circle one response)

A.

[Brand Name 3, Logo C]

B.

[Brand Name 3, Logo B]

C.

[Brand Name 3, Logo A]

Page 3
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021

Unique ID:____________

3. For [Brand Name 2], which LOGO do you
like the best? (Circle one response)

A.

[Brand Name 2, Logo C]

B.

[Brand Name 2, Logo B]

C.

[Brand Name 2, Logo A]

Page 4
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021

Unique ID:____________

4. For [Brand Name 1], which LOGO do you
like the best? (Circle one response)

A.

[Brand Name 1, Logo C]

B.

[Brand Name 1, Logo B]

C.

[Brand Name 1, Logo A]

Page 5
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021

Unique ID:____________

5. Please choose your OVERALL favorite
logo design. (Circle one response)

[Brand Name
[Brand Name
[Brand Name
D.
E.
F.
3, Logo C]
3, Logo B]
3, Logo A]

G.

[Brand Name
[Brand Name
[Brand Name
H.
I.
2, Logo C]
2, Logo B]
2, Logo A]

J.

[Brand Name
[Brand Name
[Brand Name
K.
L.
1, Logo C]
1, Logo B]
1, Logo A]

Page 6
! of 6
!
OMB# 0910-0796   Exp. 07/31/2021