Please verify your information

Please take a moment and submit your responses to the questions to verify we have everything correct about you for your upcoming online focus group!

After completing this form you will be redirected to a page to sign your participation consent as well so we have everything we need from you on file for your study.

  • Please enter the email you have with us.
  • What is the best number to contact you at via phone?
  • Enter the year you were born, like 1999 or 1972.
    Please enter a number from 1900 to 2050.
  • Which best describes the gender to which you most identify?
  • Have you EVER participated in a focus group or research project involving a lawsuit or legal issue?
  • Which US County, Parish, or Township do you live in?
  • What is your race or ethnicity? If you are mixed race, select all races you represent.
  • Which best describes the highest level of education you have had the opportunity to complete?
  • Typically do you consider yourself more of a Democrat, Republican or something else? Even if you don't vote, how do you think about public policy?
  • Do you work in, or have any training in any of the following industries or fields? Select all that apply.
  • Do you have any children under the age of 18 at home?
  • Which best represents your current marital status?
  • Do you own or rent your primary residence?
  • Which best describes your current employment status?
  • Have you, or anyone in your circle of family or friends ever been employed by, know, or are affiliated with any of the following organizations, people, or companies?
  • How would you like to receive your participation incentive? Digital payments are ONLY sent to the email address we have on file for you.
  • Please enter your mailing address so we can mail you your study information in addition to the email information you will receive from us. Include your CITY, STATE, and ZIP CODE as well.
  • This field is for validation purposes and should be left unchanged.