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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?
Yes
No
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3.
CONTACT INFO
Please provide the following:
(Required.)
Name
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Address
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Apt # if applicable
City/Town
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State/Province
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ZIP/Postal Code
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Email Address
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Phone Number
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4.
Do you identify as…
(Required.)
Male
Female
Transgender
Non-Binary
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5.
What is your age please?
(Required.)
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6.
In what age range do you fall?
(Required.)
Under 20
20-24
25-34
35-44
45-55
56-64
65 or older
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7.
In order to represent all groups equally, which of the following best describes your ethnic background?
(Required.)
Asian
Black/African American/Black American
White/Caucasian
Hispanic/Latino
American Indian/Alaska Native
Pacific Islander/Hawaiian Native
Multi-Racial
Other (please specify)
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8.
Have you, yourself, participated in a marketing research focus group or one-on-one interview in the past six months?
(Required.)
Yes
No
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9.
If you have participated in a focus group in the last 6 months please list the topic(s). If none put N/A.
(Required.)
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10.
Are you currently scheduled to participate in any marketing research studies?
(Required.)
Yes
No
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11.
What is your employment status? Are you…
(Required.)
A full-time employee
Working part-time
Laid-off/looking for work
A stay-at-home parent
Retired
Current student either part-time or full-time
You have your own side business, for example, selling homemade jewelry, paid handy-man projects, etc.
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12.
Where are all the working members of your household, including yourself, employed by, previously employed by or retired from?
(Required.)
Self- Job title & Employer:
Spouse/Partner-Job title & Employer:
Other- Job title & Employer:
Other- Job title & Employer:
Other- Job title & Employer:
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13.
Have you, yourself, ever been employed by a retail or wholesale distributor or manufacturer of hair care or other health and beauty products or as a beautician, hair stylist, or cosmetician?
(Required.)
Yes
No
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14.
Which of the following statements best describes your situation regarding your role in making the purchasing decisions for health and beauty care products that you, yourself, personally use?
(Required.)
I buy and choose the products
I buy but someone else chooses the products
Someone else buys, but I choose the products
Someone else buys and I do not influence the selection
I use whatever is available / someone else’s products
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15.
Which of the following phrases best describes the length of your OWN hair?
(Required.)
Micro (short afro, buzz cut, fade. Etc.)
Very Short (neck / tapered)
Short (ear length or shorter)
Medium (ear to shoulder length)
Long (shoulder length)
Longer than shoulder length
I am bald
