Skip to content
Consumer Study - $100
*
1.
Considering the location and computer you will be joining the interview from, what type of computer will you be using?
(Required.)
PC Laptop or desktop With Webcam
MAC Laptop or desktop With Webcam
PC Laptop or desktop WITHOUT Webcam
MAC Laptop or desktop WITHOUT Webcam
CHROMEBOOK
Tablet
I want to do the study on the phone
*
2.
Contact Info
(Required.)
Name
Phone
E-Mail
State
Gender
Age
*
3.
Employment Status
(Required.)
Full time
Part time
unemployed
retired
homemaker
student
*
4.
Current or previous
(Required.)
occupation
industry
*
5.
Which, if any, of the following conditions have you been diagnosed with or told you have by a doctor or other healthcare professional?
******NOT REQUIRED (REALLY) *********
(Required.)
a. Arthritis, including Rheumatoid or Psoriatic Arthritis
b. Cancer
c. Chronic Obstructive Pulmonary Disease (COPD)
d. Diabetes (Type 1 or Type 2)
e. Epilepsy
f. Heart disease or heart failure
g. High blood pressure / hypertension
h. High cholesterol
i. Kidney disease
j. Immunocompromised state (weakened immune system)
l. Do not have any conditions
Other (please specify)
Current Progress,
0 of 21 answered