Focus Group Oct. 9th Survey
What is your first name?
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List your complete mailing address including zip code. This is needed to send your payment.
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What is your date of birth?
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If employed, please list employer and title. If no, write n/a.
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What is your highest level of education?
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What is your highest level of education?
Have you participated in a Focus Group before?
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Have you participated in a Focus Group before?
If yes, what kind of focus group? If no, write n/a
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Have you ever been on a jury? If yes, tell us a little about it.
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What do you think about people who sue other people? Do you think it can be warranted?
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Do you or a family member work in a hospital or clinic in WI? If so, where and what profession?
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What do you believe surgical complications are usually the result of?
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What do you think about the U.S. Healthcare System?
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What do you think about the U.S. Healthcare System?
Have you ever filed a lawsuit? If yes, was it a personal injury or medical malpractice law suit?
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Do you or any family members have a background in healthcare? If yes, please explain.
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Do you or any family members have a background in law? If yes, please explain.
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Do you or any family members have a background in health insurance? If yes, please explain.
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Have you or any family members ever had a bad experience with surgery?
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Have you or any family members ever had a bad experience with surgery?
If yes, what can you share about your experience? If no, write n/a.
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Do you think there are times that doctors and healthcare facilities should be held accountable for outcomes of patients? If yes, please explain.
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Do you think that sometimes bad things can occur in healthcare and it's not really anyone's fault? Please explain.
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Participation in the Focus Group requires internet access, and use of Zoom. Do you have access to both, and do you know how to use Zoom?
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Do you have a quiet and private place to partake in the Zoom call?
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Do you have a quiet and private place to partake in the Zoom call?
Payment of $100 will be mailed to you by the law office once you have stayed for the full Focus Group session. You understand and agree that you will be paid by check, and that your full participation is required in order to receive payment.
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Payment of $100 will be mailed to you by the law office once you have stayed for the full Focus Group session. You understand and agree that you will be paid by check, and that your full participation is required in order to receive payment.
Confidentiality Statement: I understand that this screening is for potential participation in a legal Focus Group. If selected, I agree to keep all case materials confidential and provide honest feedback. I agree to hold everything about this case in strictest confidence. I agree that my participation in the viewing and commenting, and the discussion of the case is part of the attorney-work product privilege and is confidential. I will not talk about this case to anyone after I leave the Focus Group. I agree not to discuss or divulge, in any form of communication, any discussion or information to any source. In return, I understand that all information I provide about myself will be held in strictest confidence. I understand that this case is real. Therefore, I will do my best to arrive at an honest and fair decision. I understand that I am an independent contractor and am not an employee of the parties involved. I will be using my own computer, and will be participating in a private area where there are no other people. I understand that I will only be compensated if I fully participate and share my opinion, and stay for the entire 3 hours. If chosen, I will show up on Zoom on time. Do you agree with the terms above?
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Confidentiality Statement: I understand that this screening is for potential participation in a legal Focus Group. If selected, I agree to keep all case materials confidential and provide honest feedback. I agree to hold everything about this case in strictest confidence. I agree that my participation in the viewing and commenting, and the discussion of the case is part of the attorney-work product privilege and is confidential. I will not talk about this case to anyone after I leave the Focus Group. I agree not to discuss or divulge, in any form of communication, any discussion or information to any source. In return, I understand that all information I provide about myself will be held in strictest confidence. I understand that this case is real. Therefore, I will do my best to arrive at an honest and fair decision. I understand that I am an independent contractor and am not an employee of the parties involved. I will be using my own computer, and will be participating in a private area where there are no other people. I understand that I will only be compensated if I fully participate and share my opinion, and stay for the entire 3 hours. If chosen, I will show up on Zoom on time. Do you agree with the terms above?
I understand this will be recorded for the law firm to study and prepare for trial. I give my consent to be recorded.
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I understand this will be recorded for the law firm to study and prepare for trial. I give my consent to be recorded.
You will be notified by email if you are chosen, and may also receive a phone call or text. Which do you prefer?
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You will be notified by email if you are chosen, and may also receive a phone call or text. Which do you prefer?
Would you like to be notified about other legal focus group opportunities?
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Would you like to be notified about other legal focus group opportunities?