1.Are you available to participate in a 90 minute focus group discussion on Healthcare happening on Sept 17 or 18 at our office in Doral? These groups pay $175 cash for your participation.(Required.)

Yes, available Wednesday, Sept 17th at 6:00 pm

Yes, available Wednesday, Sept 17th at 8:00 pm

Yes, available Thursday, Sept 18th at 6:00 pm

Yes, available Thursday, Sept 18th at 8:00 pm

I'm available at any of these times

No, I'm not available

2.What is your gender?(Required.)

Male

Female

Non-binary/genderqueer

3.Into what age category do you fall?(Required.)

Under 18

18-25

26-34

35-44

45-54

55-64

65+

4.What is your ethnicity?(Required.)

Asian or Asian American

Black or African American

Hispanic or Latino

White or Caucasian

Another race