Females 18-45
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 Group via Desktop/Laptop with Webcam (NO CHROMEBOOK/TABLETS/PHONES)

Tuesday June 21st or Wednesday June 22nd 2022

Times Currently Available: MUST JOIN 15-MINS EARLY (3-hr commitment)

10:00AM-12:45PM ET / 9:00AM-11:45AM CT / 7:00AM-9:45AM PT

1:00PM-3:45PM ET / 12:00PM-2:45PM CT / 10:00AM-12:45PM PT

4:00PM-6:45PM ET / 3:00PM-5:45PM CT / 1:00PM-3:45PM PT

Compensation: $50-$100 Pre-Paid Visa (if chosen) to be mailed 8-10 weeks after full participation.

This is a 2-part session.  You must be available for the full 2 hours and 45 minutes, although you may be released after the first hour.

Log in 15 minutes before the start time in case of any technical issues.

Part 1: Everyone will participate in Part 1: 1 hour Online Survey, Incentive $50, if chosen.

There will be a 10-15 minute break where we ask you to wait patiently while the selection is made for part 2.

Part 2: Some will be selected to continue to Part 2: 90 minute Webcam Focus Group, for an additional Incentive of $50, if chosen.

If you are selected for part 2, you will receive and email and a phone call alerting you that you have been selected. You will use QualBoard Video Chat to connect for the webcam focus group.

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
What was your gender at birth? *
What gender do you most identify with?   *
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) * *
The Make/Model of your Cell Phone * *
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? * *
Are you a parent/legal guardian.... *
If yes, how old are they? * *
Required
PLEASE SELECT THE FOLLOWING IN YOUR HOUSEHOLD.... * *
S1.  Do you or any members of your immediate family work in…? *
Required
S5. Have you been told by a healthcare professional that you are in or have begun menopause?   *
S6. Have you had any of the following procedures, or been diagnosed with the following conditions? *
Required
S7. Which of the following best describes your current reproductive health status? *
S8. Which of the following statements best describes you currently? *
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