Health and Wellness Research in Alabama

Health and Wellness research in Alabama

SIS International Research is working on behalf of a research organization that is oﬀering a Health and Wellness screening in which your insurance company will pay for the screening. There will be no out-of-pocket expense to you.

Respondents will complete an on-site survey and will be tested for Cholesterol, Glucose, Airborne Allergies, Food Sensitivity, Cancer Markers, Cardiac Markers, Thyroid/ Hormone, and Comprehensive Metabolic Testing as well as other Wellness Panels. All with one simple blood draw.

Families can be tested together as a group. The process will last 30 minutes and you will be compensated $75.00 for your time and you will get a free 3 month subscription to an app called "Fit Radio".That is a workout music app with coaching feature. In addition you will get an I-FIT activity monitor.

The study will take place in Montgomery, AL on Monday March 12th 2018.

If you are interested in participating please complete the questions below

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* 1. What is your contact information?

Full Name

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Have you participated in this research study before?

Yes

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* 3. Do you own a smartphone?

Yes

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* 4. How often do you exercise in a month?

1-2 times a month

3-5 times a month

More than 5 times a month

Never

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* 5. What is your favorite type of activity?

Treadmill

Cycling

Strength Training

Elliptical

Swimming

Walking

Other (please specify)

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* 6. Which of the following statement, best describes your opinion regarding GMO Foods (Genetically Modified Foods)?

I have no knowledge or understanding of GMO foods.

I have some knowledge of GMO foods, but I do not avoid them.

I have extensive knowledge of GMO foods and make efforts to avoid them.

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* 7. How many hours of sleep do you typically receive per night?

Less than 5 hours

5-8 hours

More than 8 hours

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* 8. Have you had any of the following symptoms in the past 12 months?

Stomach Pain

Headache

Fatigue

Ear ache

Stuffy Nose

Soar Throat

NONE

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* 9. In regards to medical insurance, which company provides your health insurance coverage?

Aetna

Blue Cross Blue Shield

Cigna

Humana

United Healthcare

Ambetter

Medicaid

Medicare

Tricare

No Insurance/Self Pay

Other (please specify)

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* 10. INSURANCE PLAN:

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* 11. MEMBER ID #:

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* 12. Date of Birth:

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* 13. Is this policy a PPO, POS, EPO or HMO?

PPO

POS

EPO

HMO

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* 14. Does this policy have or does your card show you have an HSA, HRA or FSA?

Yes

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* 15. Have you completed any of the following blood tests in the last 12 months?

Allergy Screening

Biometric Screening (Cholesterol/Glucose)

Cancer Screening

Genetic Screening

Hormone Therapy

NONE

Other (please specify)