Pancreatic Cancer (Patients or Caregivers)

Thank you for your interest in our upcoming Pancreatic Cancer study with Plaza Research Paramus.

As with all Plaza Research studies, participants are booked on a first come first serve basis. Not all participants who complete this pre-questionnaire will qualify for this study, nor will everyone receive a callback. Please do not call in reference to this study. If you pre-qualify, a recruiter will contact you with further questions and details.

Topic: Pancreatic Cancer
Who: Pancreatic Cancer Patients and Caregivers
When:Tuesday, February 7th or Thursday February 9th @ various times
Length:90 minutes
Where: In-Home

By clicking below, you are confirming you understand the above statements and policies. You are also agreeing to fill out this survey honestly to the best of your knowledge.

Question Title

* 1. Contact Information

Name

Age

Address

Address 2

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Are you or is any member of your household or is anyone that you are especially close to and speak with very often currently employed by or affiliated with anyone:

In Advertising/Promotions/Public Relations

In Market Research or Marketing Consulting

In News Media: TV, Broadcast, Newspaper, Magazine or On-line/Internet news coverage

In Medicine or Health Care – any capacity including clinical trials

In the Manufacture, Distribution, Marketing or Sale of pharmaceuticals

None of the above

Question Title

* 3. When – if ever – did you last participate in a research study – such as a consumer panel, a discussion group, individual interview or on-line discussion – in which you were paid for sharing your opinions as an expert in your area of specialization? Was that:

Within the past 3 months

Between 3 and 6 months ago

More than a 6 months ago

Never (you have never participated)

Question Title

* 4. Are you currently in any pharmaceutical company’s research project – either as a clinical investigator, consultant or in any other capacity?

Yes

Question Title

* 5. Are you currently dealing with pancreatic cancer or are you a primary caregiver for an adult with pancreatic cancer?

Patient

Caregiver