Copy of Juror Background Information Survey for Focus Group

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* 1. Please enter your full name:

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* 2. Please enter your current address:

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* 3. Please enter your email address:

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* 4. Please enter your telephone number:

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* 5. What is your highest level of education?

High School

Associate Degree

Bachelor's Degree

Master's Degree

Doctorate or Higher

Other

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* 6. What is your current occupation?

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* 7. Have you ever been involved in a lawsuit, either as a plaintiff or a defendant?

Yes

No

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* 8. Have you or anyone close to you ever been involved in a personal injury case?

Yes

No

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* 9. Have you ever served on a jury before?

Yes

No

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* 10. Have you ever served on a focus group before?

Yes

No