Questionnaire Example
Summons Example


For identifying information, please enter the following:
  • Enter your 9 digit Participant Number(located next to your name and address on the form you received in the mail). Click on the "Questionnaire/Summons Example" on the left to help you locate your participant number. You will need to enter this participant number each time you log in.
  • Enter the first three letters of your last name.
  • Enter your Date of Birth. Please enter the birth year as four digits (i.e. 1956)
It will take approximately 10 minutes to complete the Questionnaire or Summons. Your responses will not be retained if you exit before completion of the entire Questionnaire or Summons.
Participant Number
The first three LETTERS of your last name (excluding hyphens, apostrophes, spaces, etc)
Date of Birth / /