HTML For On Page Survey - Monetizing Drug Name

[REIMktg]

I am #2 for a 12000/mo exact match drug name site (only getting 100-150 hits a day), the active ingredient name, not the trademark name. But it is not making any money.

Have tried different adsense ad placements, image, text, size everything. Even affiliate pharmacies and clickbank info on natural remedies for the conditions the drug treats - everything.

Wanted, out of cheesy desperation, to put a survey on the site asking them 1 question for what they are searching for - I would list 6 possibles and then maybe an "other" where they can fill it in.

I Googled and tried, several "pollcode" type sites but none of them seem to work for me. learnmyself.com pollcode looks perfect but does not connect to their database and returns an error. Cannot even find a script that will work and I have tried several but all were very old and dated.

Any advice on where to get some simple on page survey html that will not take them to another site like pollcode and wufoo both take to another site. These users will not do this they will just bail and search again.

Or, any advice on monetizing would be welcome.

Thanks.

 

[REIMktg]

Found 99polls - works fine. My 94% bounce rate 11 second visitors are actually voting already. 75% are voting that they are coming to the site for product info. 25% for discounts on purchasing.

Any advice on monetizing?

 

[Barclay&Riddell]

Email/zip submits. Frame it as you're offering people the chance to win stuff all in exchange for their input on what they came to the site for. Say you need the info to better pander to what your visitors want.