Corona Insights Health and Safety Information Focus Groups

1. What county do you live in?

What county do you live in?

2. In what year were you born? (enter 4-digit birth year; for example, 1976)

In what year were you born? (enter 4-digit birth year; for example, 1976)

3. Do you own a cell phone?

Do you own a cell phone? Yes, I do

No, I do not

4. Have you used a tobacco product in the past 6 months?

Have you used a tobacco product in the past 6 months? Yes

5. Please enter your contact information and a Corona Insights representative will be in contact with you shortly if you meet the basic qualifications for the research project.

Please note that we are not selling anything and that these groups are for research purposes only. To view our privacy policy, please visit:

http://coronainsights.com/research-privacy-policy/

Please enter your contact information and a Corona Insights representative will be in contact with you shortly if you meet the basic qualifications for the research project. Please note that we are not selling anything and that these groups are for research purposes only. To view our privacy policy, please visit: http://coronainsights.com/research-privacy-policy/ Name:
Phone Number: