$175 Visual Technology Study - Los Angeles & New York

About the study

Thank you for your interest in the upcoming Visual Technology Study taking place in Los Angeles (near Santa Monica) and New York (Manhattan)! This study is 90 minutes long and pays $175 per person.

We are looking for everyone ages 5 and up including family members to participate either together or separately; specifically children, siblings, parents, and grandparents.

Please share this survey with friends/family members who may want to participate with you or with their own family. Even if you do not have family members, we need non-family participants as well.

Thank you and we look forward to having you participate.

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* 1. General Information

Full Name:

Email:

Phone:

Age:

Gender:

City, State:

Zip Code:

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* 2. What is your date of birth?

DOB

Date

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* 3. Which location are you signing up for?

Los Angeles (LA)

New York (NYC)

Other (please specify)

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* 4. Are you willing/able to:

	Yes	No
Speak and understand English?	Speak and understand English? Yes	Speak and understand English? No
Apply/wear one or two items provided for the duration of your session including hoodies, face masks, glasses, makeup, and other accessories? Children under 18yo will not be asked to apply makeup.	Apply/wear one or two items provided for the duration of your session including hoodies, face masks, glasses, makeup, and other accessories? Children under 18yo will not be asked to apply makeup. Yes	Apply/wear one or two items provided for the duration of your session including hoodies, face masks, glasses, makeup, and other accessories? Children under 18yo will not be asked to apply makeup. No
Have moderators take audio and videos of you depicting different scenarios and actions (standard actions that simulate household tasks e.g. pretending to work at an office desk, walking or talking) for this study?	Have moderators take audio and videos of you depicting different scenarios and actions (standard actions that simulate household tasks e.g. pretending to work at an office desk, walking or talking) for this study? Yes	Have moderators take audio and videos of you depicting different scenarios and actions (standard actions that simulate household tasks e.g. pretending to work at an office desk, walking or talking) for this study? No
Move your head, walk and move around without assistance and without causing dizziness/vertigo?	Move your head, walk and move around without assistance and without causing dizziness/vertigo? Yes	Move your head, walk and move around without assistance and without causing dizziness/vertigo? No

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* 5. What is your native language?

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* 6. What other languages do you speak?

English

Spanish

Chinese

Tagalog

Vietnamese

Arabic

Korean

Portuguese

Russian

Japanese

French

German

Other

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* 7. Do you authorize Probe and its clients to contact you ahead of your scheduled appointment if necessary?

Yes

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* 8. Please select which, if any, of the following apply to you:

Your doctor has ever said that you have a heart condition.

You currently have or have, in the past, had chest pain.

You are currently undergoing physical therapy treatment.

You lose your balance because of dizziness or ever lose consciousness.

You have a bone or joint problem (for example: back, knee, or hip) or have had any injuries in the past 3 months that could be made worse by a change while participating.

There is anything else that would prevent/limit you from taking part in this study.

None of these apply to me

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* 9. Do you or any member of your immediate family work for any of the following companies OR in media and journalism?

SAMSUNG, APPLE, IBM, GOOGLE, FACEBOOK/META, MICROSOFT, HUAWEI, DELL, XIAMOI, HP, OPPO, ACER, ASUS, LENOVO, HTC, SONY, FOXCONN

Yes, I or a member of my family have worked for one of these companies or in these industries

$175 Visual Technology Study - Los Angeles & New York

About the study

Question Title

* 1. General Information

Question Title

* 2. What is your date of birth?

Question Title

* 3. Which location are you signing up for?

Question Title

* 4. Are you willing/able to:

Question Title

* 5. What is your native language?

Question Title

* 6. What other languages do you speak?

Question Title

* 7. Do you authorize Probe and its clients to contact you ahead of your scheduled appointment if necessary?

Question Title

* 8. Please select which, if any, of the following apply to you:

Question Title

* 9. Do you or any member of your immediate family work for any of the following companies OR in media and journalism? SAMSUNG, APPLE, IBM, GOOGLE, FACEBOOK/META, MICROSOFT, HUAWEI, DELL, XIAMOI, HP, OPPO, ACER, ASUS, LENOVO, HTC, SONY, FOXCONN

* 9. Do you or any member of your immediate family work for any of the following companies OR in media and journalism?

SAMSUNG, APPLE, IBM, GOOGLE, FACEBOOK/META, MICROSOFT, HUAWEI, DELL, XIAMOI, HP, OPPO, ACER, ASUS, LENOVO, HTC, SONY, FOXCONN