Introduction Section

Plaza Research Houston is conducting a discussion with 50-64 year old consumers on Healthcare. The discussion will take place on Tuesday, December 19th or  Thursday, December 21,  2017 throughout the day. If you qualify and participate, you will $150 for 2.25-hours of your time. 
 
Please answer the questions below. If you look like a match, we will contact you by telephone.  

**Due to the large response to our surveys, we are only able to contact those that look like a match. Please continue to answer future studies, as you may be a match to those.

* 1. Please provide us with the following information. We will be contacting you by telephone if you seem like a match. 

* 2. Alternate Contact number

* 3. What is your age? Whole number, no ranges or words

* 4. Who in your household is responsible for selecting the family doctor or specialists you and your family use?

* 6. How do you pay for Primary Care visits, hospital and other medical services?

* 7. Which of the following area hospitals have you ever heard of?

* 8. Which of the following area hospitals would you consider visiting for your healthcare needs, if any?

* 9. Have you or has your significant other had a partial or full joint replacement of the hip, knee, ankle, wrist, shoulder or elbow at a Houston area facility in the past two years?

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