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Nielsen Neuro Lab:Boston
Thank you for your interest! Our studies take place at our office in Boston and take no more than 1 hour at most. Pay ranges from $75 to $100 (depending on the study). You'll leave the study with your VISA gift card! In order for us to see if you qualify, please fill out the following questionnaire to the best of your ability. If you qualify for a study, we will contact you soon by phone to schedule.

Please note that our company is certified by an independent review board (IRB) and we abide by their guidelines. IRB certification signals that the research has been through rigorous review by a panel of independent researchers to ensure that participant rights are safe guarded. All information gathered throughout this process is kept strictly confidential. Should you have any questions about this company, please see our website at www.nielsen.com/neurolabs/boston
First Name
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Last Name
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Phone number
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Email address
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Please select the age range that best describes you:
Date of birth:
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Are you:
City:
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State:
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Which of the following ranges best describes your total yearly HOUSEHOLD income?
Which of the following best describes your ethnic background?
What is the highest level of education you have completed?
What is your employment status?
Are you comfortable undergoing an EEG testing procedure?
Are you currently pregnant or nursing?
Your hearing is:
Your vision is:
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Are you right handed, left handed, or ambidextrous?
Have you been diagnosed/treated for?
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Have you been diagnosed/treated for?
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Have you been diagnosed/treated for?
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Have you been diagnosed/treated for?
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Have you been diagnosed with any other type of neurological or psychological illness?
In the last 6 months, have you used any psycho-active drugs (mood altering, recreational drugs, or behavioral drugs)?
Are you currently recovering from or experiencing symptoms of an allergy, cold, flu, or fever?
Are you able to sit for an hour without any discomfort or chronic pain?
Do you have any of the following?
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Have you participated in a focus group or usability study for which you were compensated in the past 3 months?
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Do you or does anyone in your household work for any of the following?
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Are you currently participating or scheduled to participate in any marketing research projects with us or any other market research company?
You will be asked to complete some visual exercises prior to your participation in the study. After completing these visual exercises, there is a small chance you might not meet the requirements to participate in the study. Are you willing to complete these visual exercises?
Do you have a valid photo ID (so we can verify your name and age)?
Are you willing to sign a consent and confidentiality form when you come in for a study?
Please select all times you could potentially participate in a study Monday – Friday:
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Please let us know how you most recently heard about us:
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Would you like to opt in to be contacted about future study opportunities with Nielsen Neuro Lab: Boston?
You can opt out at any time.
Please indicate which of the following types of products you have purchased for your household in the PAST 12 MONTHS:
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Please indicate which of the following types of products you have purchased for your household in the PAST 6 MONTHS:
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Please indicate which of the following types of products you have purchased for your household in the PAST 3 MONTHS:
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Which of the following pets live in your household?
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Which of the follow brands of dog food have you purchased and/or fed your pet in the PAST 3 MONTHS?
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Which of the following types of stores have you shopped for dog food in the PAST 3 MONTHS?
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How many children under 18 years of age do you have?
Please enter "N/A" if you do not have children
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What are the ages of your children under 18 years of age?
Examle: 6 months, 8, 17, etc. Please enter "N/A" if you do not have children
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If you are a man, how many times a week do you shave your face? If you are a woman, please enter 0
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Please select which of the following retailers you have shopped for razors:
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Which brand of men's razors do you typically buy?
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Which brand(s) of feminine hygiene pads do you typically buy?
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How much of your household's grocery shopping do you, yourself, do?
Which of the following have you consumed in the past 7 days?
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Which of the following types of products have you purchased in the past 3 months?
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Which of the following brands of coffee, packaged in a bag, have you purchased in the past 6 months?
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Please indicate how likely you are to purchase the following brands of packaged coffee.
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Definitely would buy
Probably would buy
Might or might not buy
Probably would not buy
Definitely would not buy
Starbucks
Dunkin’ Donuts
McCafe
Peet’s Coffee & Tea
Green Mountain
Folgers
Gevalia
Eight O’Clock
Seattle’s Best
Maxwell House
Please indicate how likely you are to purchase the following brands of kids single serve beverages in the future.
Please select all that apply
Definitely would buy
Probably would buy
Might or might not buy
Probably would not buy
Definitely would not buy
Apple & Eve Juice Boxes
Capri Sun Juice Drink Pouches
Hi-C Juice Drink Boxes
Horizon Organic Milk Boxes
Juicy Juice 100% Juice Boxes
Minute Maid Boxes and Pouches
Store brand kids single serve beverages
Thinking about your recent purchasing history for kids single serve beverages, out of the last ten purchases, how many times did you purchase the following brands.
0 of the last 10 kids single serve beverage shopping trips
1-2 of the last 10 kids single serve beverage shopping trips
3-4 of the last 10 kids single serve beverage shopping trips
5-6 of the last 10 kids single serve beverage shopping trips
7-8 of the last 10 kids single serve beverage shopping trips
9-10 of the last 10 kids single serve beverage shopping trips
n/a I did not purchase any of these brands
Apple & Eve Juice Boxes
Capri Sun Juice Drink Pouches
Hi-C Juice Drink Boxes
Horizon Organic Milk Boxes
Juicy Juice 100% Juice Boxes
Minute Maid Boxes and Pouches
Store brand kids single serve beverages
Below is a list of statements about beverages and kids. Please select the one that best describes you.
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