$200 LA Technology & Fitness Study

Study Information

Thank you for your interest in the $200 LA Technology & Fitness Study! The study lasts up to 1hr and 15 mins and involves testing a new technology product and performing up to 30 minutes of exercise.

Feel free to share this survey with any friends or family that may be interested as well. Thank you for your time and we look forward to having you participate!

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* 1. Contact Info

Full Name:

Email:

Phone:

Age:

Gender:

City, State you live in:

DOB:

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* 2. Which of the following best describes your ethnicity?

Black or African American

South Asian

Southeast Asian

East Asian

Indigenous Peoples of North America

Alaskan Native

Hawaiian or Pacific Islander

Northern/Eastern European

Southern European

Hispanic or Latino

Middle Eastern

North African

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* 3. Which of the below options best describes your skin tone?

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* 4. What is your height without shoes on?

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* 5. What is your approximate weight (in lbs)? Please enter the number only without words like "lb" or "pounds".

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* 6. From the following list of activity levels 0-9, please select the one that best describes you:

We need individuals of all activity levels and experience so please be honest!

0 - Less than 30 minutes of moderate physical activity 3x per week (e.g., golf, bowling, yard work, walking)

1 - 30 minutes of moderate physical activity 3X per week (e.g. golf, bowling, yard work, walking)

2 - At least 90 minutes of moderate physical activity, per week (e.g. golf, bowling, yard work, walking)

3 - 90 minutes or more of vigorous physical activity per week (e.g. running, swimming, cycling, brisk walking)

4 - 2-3 hours of vigorous physical activity per week (e.g. running, swimming, cycling, brisk walking)

5 - 3-5 hours of vigorous physical activity per week (e.g. running, swimming, cycling, brisk walking)

6 - 6-8 hours of vigorous physical activity per week (e.g. running, swimming, cycling, brisk walking)

7 - 9-11 hours of vigorous physical activity per week (e.g. running, swimming, cycling, brisk walking)

8 - At least 12 hours of vigorous physical activity per week (e.g. running, swimming, cycling, brisk walking)

9 - You were previously or are currently an active Fitness Coach/Trainer/Group Fitness Instructor with practical coach experience and a strong understanding of exercise form (e.g. instructor of spin classes, boot camp, or personal trainer).

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* 7. Please indicate which, if any, of the following apply to you:

None of these

Have a medical condition that causes pain or discomfort when moving your head, neck, shoulder, arms, wrist, and/or hands (e.g., carpal tunnel syndrome, arthritis, muscle strain, pinched nerve, neuromuscular disease)

You have a vision impairment (not able to watch a video)

You have a hearing impairment (not able to hear instructions on a loudspeaker)

You are currently pregnant

You are currently undergoing physical therapy treatment

You have a bone or joint problem (for example: back, knee, or hip) or have you had any injuries in the past 3 months that could be made worse by a change in your physical activity

You have any other physical condition that would prevent/limit you from doing any physical activity

You, anyone living with you, or anyone with whom you have had close contact have experienced cold-, flu-, or COVID-19-like symptoms in the last 14 days (such as fever, cough, shortness of breath, diarrhea, sore throat, runny nose, or trouble breathing).

You have a skin condition that could be affected by the presence of cleaning products on hard surfaces.

You have a known sensitivity or allergy to disinfecting products.

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* 8. Please indicate which, if any, of the following apply to you AND have worsened within the past 3 months.

None of these apply to me and have worsened in the past 3 months

Have diabetes

Have renal disease

Have atherosclerotic coronary vascular disease (myocardial infraction, coronary artery bypass surgery, pacemaker, angioplasty, stent)

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* 9. Have you been diagnosed with hypertension?

Yes and my standard daytime blood pressure is:

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* 10. Have you previously or do you currently have any of the following health conditions?

None of these apply to me

Loss of balance because of dizziness or ever losing consciousness

Difficulty breathing when lying down

Increasing shortness of breath with performing usual activities or exercise

Forceful or fast heartbeat

Ankle, foot or leg swelling

Recurrent pain, cramping or ache in the legs with activity such as walking that goes away with a few minutes of rest

Pain in the left side of the chest, jaw, or neck when you do physical activity

Currently or previously have chest pain when not doing physical activity

$200 LA Technology & Fitness Study

Study Information

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* 1. Contact Info

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* 2. Which of the following best describes your ethnicity?

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* 3. Which of the below options best describes your skin tone?

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* 4. What is your height without shoes on?

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* 5. What is your approximate weight (in lbs)? Please enter the number only without words like "lb" or "pounds".

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* 6. From the following list of activity levels 0-9, please select the one that best describes you:We need individuals of all activity levels and experience so please be honest!

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* 7. Please indicate which, if any, of the following apply to you:

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* 8. Please indicate which, if any, of the following apply to you AND have worsened within the past 3 months.

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* 9. Have you been diagnosed with hypertension?

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* 10. Have you previously or do you currently have any of the following health conditions?

* 6. From the following list of activity levels 0-9, please select the one that best describes you:

We need individuals of all activity levels and experience so please be honest!