Step 1 of 3 33% HiddenExpert Form Tip: Install a Payment Add-OnTo accept payments on this form you will need to install one of our payment add-ons. Important: Delete this tip before you publish the form.Contact DetailsName* First Last Email* Phone*Focus Group Location*CrestviewAre you presently summoned for jury duty or have you been summoned in the last two (2) months?* No Yes How did you hear about us?*CraigslistFacebookReferralGoogleOther Participant ProfileAge*Gender*Please selectMaleFemaleEthnicity*American IndianAsianAfrican AmericanHispanic or LatinoPacific Islander or Native HawaiianWhiteMarital Status*Please selectSingleMarriedDivorcedSeparatedWidowedNumber of childrenIf you have children, what are they ages? Employment Status*EmployedUnemployedRetiredWhere do you work and what is your profession? Your level of formal education*High schoolTrade schoolSome collegeDegree receivedMasters degreeNone of the aboveWhat was your area of concentration? Household income level*$0-25K$25-50K$50-75KOver $75KPolitical affiliation*DemocratRepublicanIndependentNone of the aboveDo you consider yourself to be more*LiberalConservativeNone of the above Legal SystemThe name or names of any OB/GYN that you or your spouse/significant other has seen for medical treatment within the last ten (10) years?* Do you think there are too many lawsuits for injuries?* Yes No Do you think that jury verdicts are too large in injury cases?* Yes No Are you or any of your immediate family employed in the field of law?* Yes No Are you or any of your immediate family employed in the field of medicine?* Yes No Are you or any of your immediate family employed in the field of law enforcement?* Yes No Are you or any of your immediate family employed in the field of transportation/trucking industry?* Yes No Do you or anyone you know well work for a radio or TV station, newspaper, magazine, or any other news organization?* Yes No Do you think the legal system works properly when it comes to awarding people money for injuries?* Yes No What changes, if any, would you make in this part of the legal system? Have you ever served on a jury or are you currently called for jury duty?*NoYesHave you ever participated in a focus group or mock trial in the past?*NoYesAre you presently summoned for jury duty or have you been summoned in the last two (2) months?*NoYes Looking for a Trial Consultant or Legal Nurse Consultant? get a quote
