In order to participate, you will need to have reliable internet service and be able to participate using your desktop computer, laptop, a tablet or iPad. You will not be able to use your mobile device to participate in the Focus Group. Which device will you use for the zoom interview? *
Required
Are you or any member of your household currently employed by any of the following types of companies? *
Required
Who is your employer? *
Your answer
Who type of business is this? What industry is this? *
Your answer
When are you 100% available free from distraction in a quiet location for a 60-min zoom 8/17? *
Required
When are you 100% available free from distraction in a quiet location for a 60-min zoom 8/18? *
Required
When are you 100% available free from distraction in a quiet location for a 60-min zoom 8/19? *
Required
Payment is only available by check and will be mailed to you 2-4 weeks after your participation You must 100% complete research to be paid . Do you agree? *
Choose
Yes I agree to be paid via check mailed to my address
Which City do you live within 60 mins of? THIS INFO WILL BE VERIFIED *
Gender *
EXACT AGE *
Your answer
Which of the following best describes your ethnic background? *
Required
What country were you born in? *
Your answer
What language do you prefer to speak at home? *
Your answer
In an average week, how many hours of English-language television, radio, newspaper, or any online media do you watch/listen to? *
Your answer
In an average week, how many hours of SPANISH-language television, radio, newspaper, or any online media do you watch/listen to? WRITE 0 IF YOU DO NOT SPEAK SPANISH *
Your answer
highest level of education you have completed *
Choose
Some College
College Grad
Some Post Grad
Post Grad
Some High School
High School Graduate
Your annual household income *
Choose
Less than $50,000
$50,000 - $75,000
$75,000-$100,000
$100,000
your current employment status *
Required
What is your current/former occupation and job title? *
Your answer
What is your current/former job industry? *
Your answer
Ages of children at home (write n/a if none) *
Your answer
your current marital status *
Choose
Married or living with a partner
Single
Divorced/Seperate
Widowed
How long ago, if ever have you been in an auto accident? WRITE NEVER IF NOT BEEN IN AUTO ACCIDENT *
Your answer
Did you call a lawyer after this auto accident? WRITE N/A IF NOT BEEN IN AUTO ACCIDENT *
Your answer
Did you hire a lawyer after this auto accident? WRITE N/A IF NOT BEEN IN AUTO ACCIDENT *
Your answer
Have you ever suffered an injury due to an accident? The injury could have been while you were at work, in a car as a driver, in a car as a passenger, on a motorcycle, on a bicycle, as a pedestrian, or in a public place. *
How many injuries due to accidents have you suffered in the past? *
Your answer
When did you suffer your most recent injury due to an accident? *
Thinking of the most serious injury you have had, how serious would you say your injuries were? *
Choose
physical injuries were “minor/not very serious” and include body aches and soreness.
include soft tissue injuries but no bone breaks or fractures.
include broken or fractured bones and/or nerve damage.
neck, back or brain surgery and/or internal bleeding.
extremely serious or catastrophic injuries and include things like paralysis, coma, loss of limbs or loss of internal organs.
n/a
Did you get professional legal help due to your injuries? *
If you were to suffer injuries today because of an accident, how likely would you be to seek legal help? *
Not at all likely
Very likely
During your research study will be re-asked some of the questions you just answered which qualified you to participate in this research. If you answer differently during or before the research, you may not be paid. Did you complete this survey honestly? *
Completion of a survey does not constitute confirmation for participation. Not all participants who apply will qualify, nor will everyone receive a callback. If you are selected to participate, you will be contacted by one of our team members to complete the screening process and confirm your participation. All surveys are for market research purposes only. There will be no direct sales or promotions as a result of your participation. Your individual responses are kept confidential, anonymous and reported only in the aggregate. *
Please confirm your cell number again for us to contact you for this study. *
Your answer
Please confirm it is okay to text you ONLY for the purpose of booking your for this research study? *
note to recruiter/referral
Your answer
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