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A national market research firm is conducting a Paid Focus Group on the topic of Health Conditions.

This study is for Males and Females ages 16-75 years old.

Qualified participants will receive $145.00 for their participation in this 2.5-Hour Paid Focus Group held next week in Center City Philadelphia. Free Parking will be provided.

If interested, please respond to the brief set of questions, and we will contact you promptly if it appears that you may qualify.

 
 
Name
   
 
 
 
* Email Address
   
 
 
 
* Best Phone Number(s)
   
 
 
 
* Gender
 
Male
 
Female
 
 
 
* Age
   
 
 
 
What is your current work status?
 
High school student
 
Full-time College/university student
 
Part-time College/university student
 
Work full-time (35 or more hours/week)
 
Work part-time (less than 35 hours/week)
 
Stay at home parent
 
Neither work nor attend school
 
Other
 
 
 
 
* What best describes your ethnic background?
 
White, or Caucasian
 
African-American
 
Asian or Pacific Islander
 
Native American
 
Hispanic
 
Hispanic mix (African American/Hispanic)
 
Other
 
 
 
Which best describes the highest level of education you have had a chance to complete?
 
Some high school
 
High school graduate
 
Some college / university
 
College / university graduate
 
Post graduate education
 
 
 
What is your marital status?
 
Single, not in a relationship
 
Single, in a relationship
 
Married
 
Living with significant other as married
 
Separated/Divorced
 
Widowed
 
 
 
Which of the following medical conditions have you been diagnosed with by your physician?
 
Asthma
 
Depression
 
Diabetes - Type 1
 
Diabetes - Type 2
 
Heart disease or a specific heart condition
 
High cholesterol
 
Lupus
 
Migraines
 
Psoriasis
 
Rheumatoid Arthritis
 
None of the Above

 
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