We are studying some of the health and food assistance programs available to help California residents. We would like to hear about your views and experiences.

If you qualify, we will schedule you for a 2-hour ZOOM group with you between Tuesday, March 3rd and Thursday, March 5, 2026. Afterwards, we will send you $175 as thanks for your time and help. This is not a sales or recruitment meeting.

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* 1. Please enter your first and last names.

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* 2. Please enter your phone number as a string of 10 digits without any additional characters (Ex: 1234567890).

*By providing my email and/or cell phone number I agree to receive communications via email, phone, and text to that number and email address from Atkins Research Global, Inc. with updates and opportunities. Standard message & data rates may apply. Text STOP to opt-out at any time. Text HELP for more info. Recurring messages. https://www.atkinsresearch.com/privacy-policy/ 

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* 3. Please enter an e-mail where you can be reached.

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* 4. May we text you at the number you provided?

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* 5. What is your gender?

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* 6. What is your age?

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* 7. What is your date of birth?

Date

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* 8. Please enter your state and ZIP Code.

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* 9. In the past 6 months, have you participated in any of the following types of research projects? Select all that apply.

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* 10. Are you the parent, guardian, or someone responsible for the care of any children under the age of 13?

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* 11. Do you expect to be the parent, guardian or responsible for the care of a child under the age of 13 in the next year?

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* 12. Do you personally have health coverage right now?

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* 13. There are different ways people get health coverage. Do you have insurance through one or more of these ways? Select all that apply.

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* 14. If you have Medi-Cal, is your Medi-Cal coverage based on blindness, significant vision impairment, or a disability qualification?

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* 15. Are you currently receiving CalFresh, sometimes called food assistance or SNAP benefits?

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* 16. Which of the following best describes your ethnic background? Select all that apply.

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* 17. Were you born in the United States or its territories, including Puerto Rico, Guam, the U.S. Virgin Islands, American Samoa or Swain’s Island or were you born in another country?

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* 18. Which of the following best describes your current immigration status? Your answers are confidential and purely for classification purposes and will not be shared with anyone outside the study.

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* 19. Which of the following best describes your current employment status?

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* 20. What was the last year of schooling you completed?

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* 21. Would you say the area where you live is more urban, suburban, or rural?

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* 22. How comfortable are you with Zoom calls?

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* 23. Do you have high speed internet access in your home that allows you to run ZOOM for 2 hours without any interruption or lag?

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* 24. To participate, you must have a personal computer (either a desktop or laptop) that has:
  • a microphone built-in or attached;
  • a front-facing camera,
  • AND high-speed access to the Internet/Worldwide Web.

Will you be able to provide this?

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* 25. We will need you to join us from a private area that is free from distractions, including children or pets. If you are in public, or if you are interrupted during the session, we will be unable to retain and compensate you. Will you be able to do this?

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* 26. In order to begin on time, we are asking all participants to sign on 15 minutes prior to the start time. Will you be able to sign on about 15 minutes early?

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* 27. If you qualify, we will invite you to a 2-hour ZOOM group with you between Tuesday, March 3rd and Thursday, March 5, 2026. Afterwards, we will send you $175 as thanks for your time and help.

Please select all of the times you can join us. All times are PACIFIC.

If you cannot join us at ANY of these times, select any box in the bottom row.

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* 28. Please enter a mailing address.

Thank you. Should you qualify, a staff member will contact you to follow up. 

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