Asian Food Study #4852 Question Title * 1. Contact Information: (Required.) First Name Last Name Phone Number Email Adresss Home Address City State Zip Code Question Title * 2. What is your age? (Required.) Question Title * 3. What is your DOB? (Required.) Date Date Question Title * 4. What is your gender? (Required.) Female Male Other (please specify) Question Title * 5. Which of the following best describes your ethnicity? (Required.) American Indian or Alaska Native Central Asian (e.g., Kazakh, Uzbek, Turkmen, Kyrgyz, Tajik) East Asian (e.g., Chinese, Japanese, Korean, Mongolian, Taiwanese, etc.) South Asian (e.g., Indian, Pakistani, Bangladeshi, Sri Lankan, Nepali, Bhutanese, Maldivian, etc.) Southeast Asian (e.g., Filipino, Vietnamese, Thai, Cambodian, Indonesian, Burmese, Laotian, etc.) Native Hawaiian or Other Pacific Islander (e.g., Samoan, Tongan, Fijian, Chamorro, Marshallese, etc.) Black or African American (e.g. African American, Afro-Caribbean, Sub-Saharan African, etc.) Hispanic/Latino/a - Mexican or Mexican American (e.g., identifies as Mexican, Mexican American, Chicano/a, etc.) Hispanic/Latino/a - Central American, South American, Caribbean, etc. (Guatemalan, Honduras, El Salvadoran, Brazilian, Peruvian, etc.) Middle Eastern or North African (e.g., Arab, Iranian, etc.) White, Non-Hispanic Other (please specify) Question Title * 6. If you are selected to participate in this study, the session will be recorded for research purposes only. This information will not be shared publicly, and will solely be used for the purposes of this project.Do you feel comfortable being recorded? (Required.) Yes No Think Group is committed to protecting the confidentiality and security of personally identifiable information (“PII”) collected during our research participant recruiting and data collection processes. We NEVER share your personal information for any reason outside of the purposes of the market research study in question, and your personal information is ONLY shared and used with our research teams if you are being seriously considered to participate in the study. We take PII privacy very seriously and NEVER sell your data for any reason.For more information regarding our privacy policy, please go to https://thinkgroupaustin.com/privacy-policy/ Next
