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Questions marked with a * are required Exit Survey
 
 
A national opinion research firm is conducting a $100.00 2-Hour Paid Focus Group (Encuesta de Opinion) with people of Hispanic background on the topic of Healthcare Services.

For this study we are looking for opinions from Hispanic/Latino Males and Females Ages 30-80, and the group sessions are done in Spanish.

We are conducting this study on behalf of a national healthcare organization, which is looking for opinions from Hispanic consumers about urgent care and emergency management services available in Spanish which they are looking to launch next year in the Greater Houston area. 

Participants will receive $100.00 paid immediately at the end of this 2-hour opinion study held Galleria Area (just off of the Southwest Freeway and I-610) west of Downtown Houston. Free Parking is provided.

We have the following afternoon & night times available:

Monday December 11th / 5:00PM-7:00PM
Monday December 11th / 7:00PM-9:00PM

If interested, please respond to the very brief 2-minute multiple choice sign-up questions and we will contact you promptly if you qualify.
 
 
 
Name
   
 
 
 
* Email Address
   
 
 
 
* Best Phone Number(s)
   
 
 
 
* What best describes your ethnic background?
 
White, or Caucasian
 
African-American
 
Asian or Pacific Islander
 
Native American
 
Hispanic
 
Hispanic mix (African American/Hispanic)
 
Other
 
 
 
* Age
   
 
 
 
* Gender
 
Male
 
Female
 
 
 
In the past year, have you been indirectly or directly impacted by a natural disaster (ex. hurricane, earthquake, flood, fire) either locally or where you have loved ones living?
 
Yes, I have been directly impacted by a natural disaster
 
Yes, someone I know has been impacted by a natural disaster
 
No, neither I nor anyone I know have been impacted by a natural disaster, but I have followed the news about them
 
 
 
How long have you lived in the greater Orlando area?
 
Less than 3 months
 
3-6 Months
 
6-12 Months
 
1-3 Years
 
3-9 Years
 
10+ Years