Adult Study

SIS International Research is conducting an adult study for Adults 18 - 75+ in the Flatiron District.

The study will take approximately 25 minutes, and the compensation is $40.

To be considered, please take the screener below.

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* 1. Contact Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What is your gender?

Female

Male

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* 3. When is you birthday? (mm/dd/yyyy)

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* 4. What is your age?

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* 5. What is your Race/Ethnicity?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American or other Pacific Islander

Multiracial

Other (please specify)

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* 6. Highest Level of Education Completed:

No high school diploma

High school graduate/GED

Some college, no degree

Associate's degree

Bachelor's degree

Graduate or professional degree

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* 7. Employment Status:

Employed or Self-Employed; Full-Time

Employed or Self-Employed; Part-Time

Unemployed

Retired

Other (please specify)

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* 8. How well do you read English?

Very well

Well

Not well

Not at all

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* 9. Has a professional diagnosed you with an intellectual disability or a psychological, behavioral, and/or learning disorder (for example, depression, ADHD or a reading disorder?

Yes

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* 10. Has a professional diagnosed you with a Neurocognitive Disorder or dementia (such as Alzheimer’s, Parkinson’s, or Lewy Body) that causes problems with your thinking and memory?

Yes

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* 11. Have you had a head injury or concussion?

Yes

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* 12. Marital Status:

Single

Married

Partner

Separated

Divorced

Widowed

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* 13. If you have any preferred times and dates please specify below (not mandatory):

Study runs week days only! Sessions typically go until 6:30 PM. We can not guarantee your preferred time, it will be first reply, first recruited. We will contact you to schedule a time via email.

1st

2nd

3rd

4th

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* 1. Contact Information

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* 2. What is your ﻿gender?

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* 3. When is you birthday? (mm/dd/yyyy)

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* 4. What is your age?

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* 5. What is your Race/Ethnicity?

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* 6. Highest Level of Education Completed:

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* 7. Employment Status:

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* 8. How well do you read English?

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* 9. Has a professional diagnosed you with an intellectual disability or a psychological, behavioral, and/or learning disorder (for example, depression, ADHD or a reading disorder?

Question Title

* 10. Has a professional diagnosed you with a Neurocognitive Disorder or dementia (such as Alzheimer’s, Parkinson’s, or Lewy Body) that causes problems with your thinking and memory?

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* 11. Have you had a head injury or concussion?

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* 12. Marital Status:

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* 13. If you have any preferred times and dates please specify below (not mandatory):Study runs week days only! Sessions typically go until 6:30 PM. We can not guarantee your preferred time, it will be first reply, first recruited. We will contact you to schedule a time via email.

* 2. What is your gender?

* 13. If you have any preferred times and dates please specify below (not mandatory):

Study runs week days only! Sessions typically go until 6:30 PM. We can not guarantee your preferred time, it will be first reply, first recruited. We will contact you to schedule a time via email.