$200 Technology Study - Los Angeles, New York, San Francisco

About this study

Thank you for your interest in this study! It will be taking place in (3) Major US Cities: New York (NY), Los Angeles (LA), and San Francisco (SF). During the survey, please indicate which city you are signing up for - sessions pay $200 for 2 hours of your time.

This study is for anyone ages 16 and up! If you have any friends, family or children under the age of 18, or older than 18, feel free to share this survey with them. We can make it so that people that know each other are scheduled for the same time so you can all come together!

Thank you and we look forward to having you participate!

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* 1. Contact Info

Full Name:

Email:

Phone:

Age:

Gender:

City:

State:

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* 2. What is your date of birth?

DOB

Date

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* 3. Which city are you signing up for?

New York City (NYC)

Los Angeles (LA)

San Francisco (SF)

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* 4. Participation in this study is open to adults as well as children who are 16 or 17 years old, as long as a parent or legal guardian can accompany them during the study. Do you have any children who would also be interested in participating?

Note - not required!

Yes, child(ren) aged 16-17

Yes, child(ren) aged 18-19

I have child(ren) in different ages

I do not have children

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* 5. Are you proficient in written and spoken English?

Yes

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* 6. Do you ever wear reading glasses (or bifocals)?

Yes

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* 7. Do you ever wear glasses for distance vision?

Yes

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* 8. Do you wear contacts?

Yes

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* 9. Which of the following best describes your hearing?

You do not have impaired hearing (can hear normally)

You have impaired hearing and use hearing aids or cochlear implants to correct it

You have impaired hearing and do not use any aids or implants to correct it (cannot hear)

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* 10. Which hand is your dominant hand?

Right

Left

Both (Ambidextrous)

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* 11. Can you independently operate a handheld device such as a laptop or tablet?

Yes

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* 12. Do any of the following apply to you?

	Yes	No
Do you have any metal implants in your upper torso or head?	Do you have any metal implants in your upper torso or head? Yes	Do you have any metal implants in your upper torso or head? No
Do you have a pacemaker?	Do you have a pacemaker? Yes	Do you have a pacemaker? No
Do you have an allergy to medical-grade adhesives (for example Band-Aids)?	Do you have an allergy to medical-grade adhesives (for example Band-Aids)? Yes	Do you have an allergy to medical-grade adhesives (for example Band-Aids)? No
Would you have an allergic reaction if you touched a potato chip?	Would you have an allergic reaction if you touched a potato chip? Yes	Would you have an allergic reaction if you touched a potato chip? No
Are you pregnant or planning to become pregnant in the next 6 months?	Are you pregnant or planning to become pregnant in the next 6 months? Yes	Are you pregnant or planning to become pregnant in the next 6 months? No

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* 13. Are you currently:

Employed full-time

Employed part-time

Unemployed

Self-employed

Student

Homemaker

Military

Retired

Unable to work

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* 14. What is your current or most recent:

Job Title:

Industry:

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* 15. Are you currently:

Employed in marketing

Employed in media

Maintaining an active blog

None of these

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* 16. Are you a resident in the state of Texas, Illinois, or Washington?

Yes

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* 17. Do you have a history of any serious medical condition that may hinder your participation in this study?

Yes

$200 Technology Study - Los Angeles, New York, San Francisco

About this study

Question Title

* 1. Contact Info

Question Title

* 2. What is your date of birth?

Question Title

* 3. Which city are you signing up for?

Question Title

* 4. Participation in this study is open to adults as well as children who are 16 or 17 years old, as long as a parent or legal guardian can accompany them during the study. Do you have any children who would also be interested in participating?Note - not required!

Question Title

* 5. Are you proficient in written and spoken English?

Question Title

* 6. Do you ever wear reading glasses (or bifocals)?

Question Title

* 7. Do you ever wear glasses for distance vision?

Question Title

* 8. Do you wear contacts?

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* 9. Which of the following best describes your hearing?

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* 10. Which hand is your dominant hand?

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* 11. Can you independently operate a handheld device such as a laptop or tablet?

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* 12. Do any of the following apply to you?

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* 13. Are you currently:

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* 14. What is your current or most recent:

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* 15. Are you currently:

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* 16. Are you a resident in the state of Texas, Illinois, or Washington?

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* 17. Do you have a history of any serious medical condition that may hinder your participation in this study?

* 4. Participation in this study is open to adults as well as children who are 16 or 17 years old, as long as a parent or legal guardian can accompany them during the study. Do you have any children who would also be interested in participating?

Note - not required!