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20-758 Health Coverage

Thank you for your interest in this upcoming paid marketing research study!

Please complete this survey to determine your eligibility for a 1-hour telephone interview the week of October 12th. If qualified and invited to participate, you will receive $75 check for completing the study.

After you fill out the survey, we will send you a confirmation email if you initially qualify. Your information is kept strictly confidential and will not be used for anything other than to recruit you for THIS study. We will not be able to reach out to people who do not initially qualify for this study or if the study is now filled.

Please enter your name

Email Address

Cell Phone Number

We will send you a text confirmation. If you do not wish to enter your cell phone and receive phone call confirmations at another number, please enter that.

Alternate Phone Number