Eye Exams
This questionnaire is a pre-screener to seek eligibility for a market research project. You do NOT get compensated for filling out this form. If you pre-qualify, you will receive a text or email from a Recruiter to call our office.  

Online Webcam 1:1 via Desktop/Laptop with Webcam (NO CHROMEBOOK/TABLETS/PHONES)

Thursday November 10th - Sunday November 20th 2022 - 7am-4pm ET (60mins must join 15-mins early)

Compensation: $100 + $25 Pre-task HW (if chosen) for full-participation.

Times are for reference only, booked by available quotas.
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First Name * *
Last Name *
Your Age * *
Your Age * *
What is your date of Birth? * *
MM
/
DD
/
YYYY
Gender * *
Ethnicity/Race * *
Required
Email * (if you have a Gmail account please enter that email address, preferred) *
Best Number to Text * *
Cell Phone Carrier * *
Alternate Number
Advanced Opinions communicates via text may we text to communicate with you? * *
Advanced Opinions communicates via email may we email you to communicate with you? * *
State *
The County you Live in (i.e., Lehigh) * *
Your Zip Code where you live * *
Are you currently * *
If you are a Student, are you
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What is the highest level of education you have completed? * *
If you are currently working, please briefly describe your employment. (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) * If not applicable, enter N/A *
What is your job title? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) * If not applicable, enter N/A *
What is the name of the company/organization you work for? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) * If not applicable, enter N/A *
If you are currently working, what industry do you work in? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) *  If not applicable, enter N/A *
(IF MARRIED OR CO-HABITATING) What is your spouse or partner’s current occupation? What Industry are they currently working in? (IF UNEMPLOYED/HOMEMAKER/RETIRED ENTER PREVIOUS) *Example: FT/Bus Driver/Transportation (If not applicable, enter N/A) *
What best represents your households annual income before taxes? (By this we mean all income brought into the home by all household members) * *
Which of the following best represents your current marital status? * *
Have you ever had an eye exam? *
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