Qualitative Bid Request
Company Name:
Contact Name:
City:
State:
Zip
:
Phone:
Fax
:
email
:
I prefer to receive
to receive my bid
:
via email
via fax
via a simple phone call
In need my proposal:
In
hours
end of day
By this date:
Study Type:
Focus Groups
IDI's
Triads
Mini-Groups (4)
Other
If Other, Specify:
Focus Groups
# of Groups:
Length of Groups (hrs):
# to recruit per group:
# to show per group:
Incentive Offered:
Respondent Type (please describe):
In-Depth Interviewing
# of Interviews:
Length of Interview:
Incentives Offered:
Respondent Type
(please describe):
Where are we holding the groups?
Subject Matter:
Automotive
Education
Financial Services
Food & Beverage
Government
Insurance
IT / Information Systems
Media
Medical/Healthcare
Pharmaceutical
Political
Telecomm
Other
If Other:
Type of Respondent:
Consumer
Executive
Management
Physician
Patient
Kids 13-18
If Medical Study:
GP/FP/IM
Neurologist
Cardiologist
If IT related:
CIO
Management
Networking Admin
Videotaping:
Yes
No
Est Project Dates:
Notes (General Info about the groups):