*1.This survey is being conducted by Adler Weiner Research in order to determine your eligibility for a focus group or interview about which you have been contacted. At no point are your individual answers ever sold or shared with our clients (aggregate data or anonymized summaries of the overall survey information may possibly be shared with our clients, however). This survey serves solely as a means for screening. Once the project has been completed this data will be deleted.  For more information please see:
Right to Opt-Out Info
Financial Incentive Info
Adler Weiner Privacy Policy(Required.)

I consent to Adler Weiner Research collecting, storing and processing my personal information for the purpose of determining my eligibility for this market research focus group or interview.

I understand and consent to the following: That should I be eligible for participation in this market research focus group or interview, my contact information (phone, email, and home address) may be shared with the client for purposes related only to this particular project and are not limited to: screening calls to further determine eligibility, sending of "homework" or pre-session assignments via email, allowing access to an online platform via email, or for in-home interviews conducted at your residence.

*2.By proceeding, you certify that all answers provided in this application are truthful, accurate, and complete to the best of your knowledge. You also confirm that you have completed this application independently, without the assistance of AI tools, chatbots, or other external aids.

Please note: The client reserves the right to disqualify and turn away any participant without compensation if any information provided is found to be untruthful, inaccurate, or generated by AI.

Do you agree with the conditions above?(Required.)

Yes

No

*3.Thanks again for your interest in our study on supplements with people that live in Southern California surrounding areas.

The study is an online survey that will take approximately 30 minutes to complete. You have between Wednesday, June 17th to Friday, June 19th to complete.

This survey will ask questions about your health, existing understanding of the influence of the gut microbiome’s effect on overall health as well as your general perception of supplements.

You will also be asked to provide your feedback on a supplement currently in development and assess the likelihood that you will try the new supplement.

You will receive a $100 digital payment for your time.

In addition two participants who return fully completed surveys will be randomly selected for a raffle bonus and will receive an additional $150 digital payment!


After the survey is completed, the client will be selecting a few participants to complete a follow up 30 minute online interview. If you are selected you'll receive an additional $65 digital payment for your time.

Please check off if you are available to participate. If you qualify and we have a spot for you in the study; we will be in touch!(Required.)

Yes I am available

No I am not available