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SmartBelt Human Data Collection Survey
Please tell us a little more about yourself for us to determine your adequacy in participating this study. Be sure to provde us the email that you would like us to send the Amazon giftcard to.
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* Indicates required question
Email
*
Your email
Your name (It will be replaced with an identifier code in the public data)
*
Your answer
What is your age?
*
< 18 years old
18-24 years old
24-30 years old
30-50 years old
More than 50 years old
Prefer not to say
What is your gender identity?
*
Male
Female
Non-binary
Prefer not to say
What is your ethnicity?
*
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Prefer not to say
Other:
Required
For considerations of study location and travel, what is the city and county you currently live in?
*
Your answer
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