Testing Opportunity for guided medical exams with a healthcare provider

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* 1. First Name

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* 2. Last Name

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* 3. Email Address

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* 4. City

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* 5. State/Province

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* 6. Country

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* 7. What kind of smartphone do you use?

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* 8. Which of the following versions of software does your smartphone operate?
If you are unsure as to the version, please go to settings on your smartphone and check under "About".  It will indicate software version there.

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* 9. Which of the following devices do you have in your home?

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* 10. Have you ever used a Telehealth program for yourself or your family?

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* 11. Are you interested in testing a product that that lets you perform guided medical exams with a healthcare provider, anytime, anywhere?

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* 12. How often do you visit your doctor?

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* 13. Do you or your children often suffer from any of the following?

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* 14. Please tell us why you feel that you and your family would benefit from this type of product in your home.

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* 15. I have updated my profile information on www.ptpa.com

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* 16. I understand that in order to qualify for this testing opportunity, my profile must be 100% complete on www.ptpa.com

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* 17. Would you like to be notified of future testing opportunities?

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