jt@probemarketresearch.com

We have upcoming focus groups next Wednesday evening THE 9TH in Downtown Manhattan on health & medications. The compensation will be $100 for the 90 minute groups. If interested, please answer ALL the questions below & return email to us. Thank you to all & please nho phone calls.

Complete Name:
Contact phone #:
Age:
Have you been diagnosed AND are being treated by a physician for any of the following medical conditions presently(check all,if any, that apply)?
Angina_____
Arthritis______
Asthma____
Diabetes______
High Blood Pressure_____
High Cholesterol or Cholesterol problems______
Obesity_______
None of the above_____

If yes to Cholesterol problems, are you currently being treated w/prescription medication(s) for your cholesterol problem(YES/NO)?

If yes to previous, what medication(s) are you currently taking for your cholesterol problem(please list all, if any, that apply)?

Has your doctor told you that your cholesterol is not yet at the level that he/she wants it to be?
YES_____
NO______


Thank you again to all.