VEHICLES/MONEY/MEDICAL

MURRAY HILL PRIVACY STATEMENT/POLICY

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* 1. Murray Hill national is conducting a study.

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. How do you identify?

Male

Female

Non-binary

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* 3. What is your age?

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* 4. What is your ethnicity?

White

Black or African American

Hispanic or Latino

Asian or Asian American

Another race

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* 5. Please indicate the Asian race or ethnic group to which you identify most.

Chinese or Taiwanese

Japanese

Korean

South Asian/Asian Indian

Vietnamese

NONE OF THE ABOVE

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* 6. Which vehicle types would you consider for your next vehicle?

Subcompact/Compact/Small sedan/hatchback

Mid-size sedan/hatchback

Full-size/large sedan

Entry SUV/compact crossover (seats 4-5)

Small SUV/Crossover (seats 5)

Mid-size SUV/Crossover (seats 5-7)

SUV/Crossover

Large SUV (seats 7+)

Minivan

Small/mid-size pickup truck

Full-size pickup truck

Sports car/coupe

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* 7. Do you send money out of the country? ( to friends/family)

Yes

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* 8. What countries do you send to?

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* 9. Which of the following best describes how you pay for your or your household’s prescription medications?

Commercial insurance (employer-sponsored or individual-managed care/ private/ HMO/ PPO/ HSA/ FSA)

Government-sponsored insurance (Medicare, Medicaid)

Entirely out-of-pocket / cash

No insurance

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* 10. We are speaking with a variety of people with different body types. To help us with this, please specify your approximate height and weight below.

Height

Weight

BMI

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* 11. Which of the following medical conditions, if any, have you personally been diagnosed with by a medical professional?

Type 1 Diabetes

Type 2 Diabetes

Pre-Diabetes

High blood pressure (hypertension)

High cholesterol (dyslipidemia)

Atherosclerosis / Coronary Artery Disease

Stroke

Heart Attack / Myocardial Infarction

Heart Failure

Obstructive Sleep Apnea (OSA)

Osteoarthritis (chronic joint pain & function)

Nonalcoholic Fatty Liver Disease (NASH/NAFLD)

Polycystic Ovary Syndrome (PCOS)

Gout (hyperuricemia)

Chronic Kidney Disease (CKD)

None of the above