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Thank you for your interest in becoming a part of the Focuscope Community. This community is a way for you to earn money sharing your opinions on products and services that you use in your everyday life. Your opinions will help to improve and develop new products. Please take a 5 minutes to complete the form below to sign up for upcoming studies. We look forward to working with you.

THE RED INDICATES A REQUIRED FIELD.

Please type in ALL CAPS.

Would you like to update your existing community profile information?
Please email us at respondent@focuscope.com.

Privacy

Focuscope respects the privacy of our respondents and clients and is committed to maintaining the security of personal information. We do not conduct sales or direct marketing. We do not rent, sell or give information to any third party for the purpose of directly marketing any products or services.

What to Expect

When a project is in the planning process, we will call or e-mail you to see if you qualify to participate. Every project has guidelines set by our clients. You will be asked a series of questions to see if you fit the guidelines set for the project and if so, you will be invited to participate in the study. There will be times that you may not qualify and if that does happen, you will remain in our database and be called for future studies.

Personal Information

*First Name
(REQUIRED FIELD)

*Last Name
(REQUIRED FIELD)

*Date of Birth
(REQUIRED FIELD)

*Gender
(REQUIRED FIELD)

Email Address

*Home Phone #
(REQUIRED FIELD)

Work Phone #

Cell Phone #

Demographic Information

Highest level of education completed:

Race

*Marital Status:
(REQUIRED FIELD)

Work Information

Employment Status?

Are you a business owner?

Company Name:

*What is your occupation?
(REQUIRED FIELD)

Other-please specify:

In what industry do you work?

Number of employees worldwide in your company:

Business trips a year:

Spouse's occupation:

If you are a student, what school do you attend?

Household Information

*Home Address
(REQUIRED FIELD)

*City
(REQUIRED FIELD)

State

*Zip Code
(REQUIRED FIELD)

County

*Are you the Head of the Household?
(REQUIRED FIELD)

What type of home is this?

Yearly family income:

How many children do you have living in your home?

Child 1

 

Birthdate

Gender

Child 2

 

Birthdate

Gender

Child 3

 

Birthdate

Gender

Child 4

 

Birthdate

Gender

Lifestyle Products and Preferences

If you are pregnant, what is your due date?

What health conditions do you have?
(Select all that apply. Hold down the <Ctrl> key to make multiple selections)

What kind of cell phone do you own?

Do you own any of the following electronic devices?
(Select all that apply. Hold down the <Ctrl> key to make multiple selections)

Which of the following describes your access to healthcare?
What is your primary method of watching television?

What pets do you have?
(Select all that apply. Hold down the <Ctrl> key to make multiple selections)
(REQUIRED FIELD)

What are your hobbies?
(Select all that apply. Hold down the <Ctrl> key to make multiple selections)

Vehicle Information

Vehicle 1 and 2, Make, Model, Year

Vehicle 1

Make

Year

Vehicle 2

Make

Year

Participation in Studies

*What is your availability for studies?
(REQUIRED FIELD)

*Your location availability:
(Select all that apply. Hold down the <Ctrl> key to make multiple selections)
(REQUIRED FIELD)

Would you travel to projects in Buffalo Grove?

Would you be interested in studies where we come to your home?

*How did you hear about us?
(REQUIRED FIELD)


If you were referred by someone or heard about us from another source, please enter it here:

We respect our respondents' privacy. Accordingly, any personal information you provide to us whether through our website or otherwise, will never be sold to another company.