(LA) Nationwide Upcoming PAID Health Conditions - October 8-October 11, 2012

Study Information

Plaza Research Los Angeles is currently recruiting for a nationwide study regarding Health Conditions. We are looking for men and women to participate in telephone interviews or focus groups. The interviews will last up to 2 hours long and include a fun homework assignment. If you qualify and participate, you will receive $200 for your participation and completed HW assignment.

Question Title

* 1. Contact information

Name:

Job Title:

Company:

Industry:

City/Town:

State:

ZIP:

Email Address:

Phone Number:

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* 2. What is your age range?

Under 18

18-29

30-39

40-49

50-59

60-69

70-75

76+

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* 3. What is your exact age?

Question Title

* 4. What is your gender?

Male

Female

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* 5. What is the highest level of education you have completed?

Less than High School

High School Grad

Some College

Bachelor's degree

Master's degree

Ph.D./Doctorate

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* 6. What is your ethnicity?

African American

Asian

Caucasian

Hispanic/Latino

Native American

Other

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* 7. What is your total household income?

Under $30,000

$30,000-$49,999

$50,000-$74,999

$75,000-$99,999

$100,000-$150,999

$151,000 or more

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* 8. Employment Status

I am a homemaker

I am a student

I am retired

I am between jobs/unemployed

I am self employed

I own my own business

I am employed as a full-time worker

I ame employed as a part-time worker

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* 9. Do you currently suffer from any of the following health issues? Please select all that apply.

Chronic Pain

Diabetes

Arthritis

High Blood Pressure

Neurological disorders

Currently pregnant