San Mateo Area / San Francisco Bay Area - Paid Focus Group on Health and Wellness. Thursday, 3/21 and Friday, 3/22 during business hours. 90 Minute Session pays $150

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First/ Last Name: *

Phone Number: *

Email Address: *

1. What is your gender?
*

Male

Female

Self-identify

2. What is your age? *

3. What is your employment status?

Employed Full-time

Employed Part-Time

Stay at home parent or caregiver

Full time student

Not Employed – looking for work

Retired

4. What is the highest level of education you have achieved?

Some high school

High school graduate

Some college

College graduate

Post graduate

5. Which of the following describes your total annual household income before taxes?

Under $50K

$50K-99K

$100K-$149K

$150K and above

6. Which of the following best describes your race/ethnic background?

Caucasian

African-American

Hispanic/Latin

Asian

Mixed Race

Other

7. How much of the actual grocery shopping do you, yourself, do for your household?

All of it

More than half but not all

I share it equally with others

Less than half

None

Required

8. In the past 12 months, have you personally used or taken any of the following?
*

Specialty skincare products - including lotions, creams or oils that contain ingredients that are beneficial to your skin (beyond just moisturizing or sun protection)

Functional foods or beverages - that you eat or drink specifically for health benefits including live, fermented, and/or nutrient dense foods (as well as those “boosted” with enhanced ingredients)

Health and wellness supplements - including pills, capsules, gummies or powders that contain ingredients to improve your health

Prescription medicines - any medications that require a prescription from a doctor

None of the above

Required

9. Do you use or take any of the following types of supplements on a regular basis?
*

Vitamins - including multivitamins or individual vitamins (like C, D, B, etc.)

Minerals - like zinc, magnesium, calcium, etc.

Herbal or Botanical - like echinacea, ginseng, ashwagandha, moringa, ginkgo biloba, etc.

Food-based supplements - like garlic, apple cider vinegar, green tea, turmeric, coconut oil/MCT, elderberry, superfoods, etc.

Prebiotics and/or probiotics

Fatty Acids - Omega 3s or 6s from fish oil, flaxseed oil, etc.

Fiber

Protein

Melatonin

Collagen

CBD

Sports Performance Supplements - including creatine, glutamine, ZMA, etc.

Homeopathy - like arnica, ignatia, nux vomica, calendula, etc.

Other Supplements - including amino acids, enzymes, etc.

None of the above

Option 16

Required

10. Do you eat any of the following types of functional foods for health and wellness purposes on a regular basis?

Boosted foods - foods that are enriched or fortified with additional vitamins, minerals, and other health-promoting components

Nutrient dense foods - foods that are naturally rich in vitamins, minerals, and other health-promoting components

Live foods - foods consumed raw and/or in a condition as close as possible to their original living state

Fermented foods - like cultured yogurt, kimchi, miso, sauerkraut, etc.

None of the above

Required

11. Which, if any, of the following grocery products have you PURCHASED in the past 6 months?
*

Salad dressing

Canned soup

Apple cider vinegar

Taco seasoning

Single-size yogurt

Frozen appetizers

Dry beans

None of the above

Required

12. Which, if any, of the following grocery products have you CONSUMED in the past 6 months?
*

Salad dressing

Canned soup

Apple cider vinegar

Taco seasoning

Single-size yogurt

Frozen appetizers

Dry beans

None of the above

Required

13. What is your experience using the following for health and wellness benefits?

Use currently

Have used in the past

Have never used, but am interested in learning more

Have never used, and don’t plan to in the future

Apple cider vinegar

Garlic

Coconut / MCT oil

Green tea

Turmeric

Ginger

14. Which of the following brand’s products have you purchased in the past 6 months?
*

Bragg

Kevita

Bob’s Red Mill

White House

Goli

New Chapter

My Kind Organics

Nature’s Truth

Olly

Garden of Life

None of the above

Required

15. Please tell me which of the following best describes you:

Very outgoing/talkative

Somewhat outgoing/talkative

Somewhat quiet/reserved

Very quiet/reserved

16. How comfortable are you expressing your opinions in a group situation?

Very comfortable

Somewhat comfortable

Somewhat uncomfortable

Very uncomfortable

Required

17. Describe your favorite all-natural, food-related health and wellness hack or ritual. Describe it in detail along with any details you’d include in a recommendation to a good friend. (Be as detailed as possible here)

1. Please tell us how much you agree with each of the following statements about your health.

Please use a 7-point scale to rate how much you agree with each statement. A 7 means you “Agree Completely” with the statement, while a 1 means you “Disagree Completely” with the statement. Choose a 2, 3, 4, 5 or 6 if you feel in-between.

I am able to live a healthy life without too much effort

I often get off track with my health

I think about how the food I put in my body affects how I feel

If I could just take a pill and get all the nutrition need, I would

I don't eat a healthy enough diet / should eat better

I will eat or drink something that doesn't taste good if it has health benefits

I don't always know if the supplements I take are benefitting me

I like to experiment with new supplements to see if they improve my health

I believe taking supplements is a critical part of a healthy lifestyle

I trust my doctors / believe that they know what's best for me

I avoid taking prescription medications whenever possible

I've dealt with a lot of side effects and other issues when taking medications

I try to solve my own health issues before seeing a doctor

Regularly going to the doctor is an important part of maintaining good health

I like to pay attention to what's popular and follow trends

I tend to look on the brighter side of things

I often feel overwhelmed by what’s going on in my life

I am able to live a healthy life without too much effort

I often get off track with my health

I think about how the food I put in my body affects how I feel

If I could just take a pill and get all the nutrition need, I would

I don't eat a healthy enough diet / should eat better

I will eat or drink something that doesn't taste good if it has health benefits

I don't always know if the supplements I take are benefitting me

I like to experiment with new supplements to see if they improve my health

I believe taking supplements is a critical part of a healthy lifestyle

I trust my doctors / believe that they know what's best for me

I avoid taking prescription medications whenever possible

I've dealt with a lot of side effects and other issues when taking medications

I try to solve my own health issues before seeing a doctor

Regularly going to the doctor is an important part of maintaining good health

I like to pay attention to what's popular and follow trends

I tend to look on the brighter side of things

I often feel overwhelmed by what’s going on in my life

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