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Data Collection Quote Sheet
Fill out our easy data collection cost estimate form and we will contact you promptly upon receiving your information. We recommend using the simple web-based form below for an accelerated response. However, you may also download the form at the bottom of the page and mail or fax it to us. If needed, use your browsers' back button to avoid losing data
on this form

*TYPES OF RESEARCH TO CONDUCT: DATA COLLECTION METHOD DESIRED:
Social
Behavioral
Evaluation
Policy
Other types of research: 		CATI Telephone Interviewing
Focus Groups
Field Research
In-depth interviews
Other Type of Data Collection:
PROJECT SPECS:
Start/End date:
Subject:
Geographic coverage:
Sample size:
Length of questionnaire:
Number of open-ended questions:
Respondent criteria:
Focus group location(s) desired:
Budget (not required for an estimate):
ADDITIONAL DELIVERABLES IF NEEDED:
Survey Questionnaire
Focus Group Recruitment Screener
Focus Group Discussion Guide
Top-Line Report/Frequencies
Banners/Cross tabulation
Full Report
Other:


Translate from English to
(language)		 Focus Group Moderator(s) - Check applicable boxes
  Female Male
  Caucasian
  African-American
  Hispanic
  Haitian (Creole Language)
  Asian (Specify Language)
  Other: 
YOUR CONTACT INFORMATION:
* Name: * Phone:
Title: Fax:
Institution, Organization
or Agency:		 * Email:
Address: Web Site:
City:  * How would you like us to reply? Phone
Fax
Email
US Mail
State:
Zip:  

  • PDF Document
    1. download & Print
      Portable Document File (PDF, 163K)
    2. Fax: 352-336-6763
      or Mail
      Ken Lyons, Vice President
      Independent Data Collection Center
      2306 SW 13th Street, Suite 806,
      Gainesville, Florida 32608