Preliminary Screening

Thank you for participating in our preliminary screening process for our upcoming research study on consumer healthcare. This study would involve participating in a 90-minute group discussion in Saint Louis Park, MN on May 23rd. All participants will be compensated $125 for their time and feedback.

During this preliminary screening you will be asked a series of questions. Please read the questions carefully and take your time answering the questions. If you meet the preliminary qualifications for this study, one of our recruiters will follow-up to complete the screening via telephone and will further explain the study details and logistics if you qualify.

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* 1. Please tell us your gender.

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* 2. What is your current age?

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* 3. For this study we would like to speak with a variety of participants. Which of the following medical conditions, if any, have you ever been diagnosed with? (Select all that apply)

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