The Missing Piece: Your Podcast Feedback
What is your age range?
18-28
29 - 38
39 - 48
49 and above
What is your gender?
Male
Female
Transgender
Nonbinary
Agen-genderqueer
Other
What Province/State do you live in?
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington DC
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Northwest Territories
Nunavut
Yukon
What is your household income?
$20,000 - $40,000
$40,001 - $60,000
$60,001 - $80,000
$80,001 - $100,000
$100,001 and above
Do you rent or own your home?
Rent
Own
Other
How many children do you have under the age of 18?
One
Two
Three
Four
NA
Other
What is the highest level of education you have completed?
High School Diploma/GED
Associate Degree
Undergraduate Degree
Masters Degree
PhD
Other
Which of the following are you likely to do in the next 18 months?
Change banks
Purchase sports equipment
Purchase television or other major consumer electronics
Visit a sporting goods retailer
Rent a vehicle
Applying for a mortgage
Switch cable, phone or internet service providers
In the past 6 months, which of the following hobbies have you participated in?
Hiking
Yoga
Gardening
Travel
Watching sports
Attending theatre
Going to the movies
Baking
Exercising
Meditation
What type of sponsor do you think would be a good fit for Lydia Amputees Foundation?
Airline
Automotive
Car Rental
Credit Card
Financial Services
Furniture & Appliance Retailer
Hotel
Insurance (Life)
Insurance (Property & Casualty)
Investment Advisor
Law Firm
Mortgage Broker
Retail
Smartphone Manufacturer
Sport Equipment/Apparel
Telecommunications
Travel
Who is your current financial institution?
Bank of America Financial Center
JP Morgan Chase
Capital One
Citibank
Goldman Sachs
Wells Fargo Bank
Truist
PNC Bank
TD Bank
Citizens Bank
Morgan Stanley
Ally Bank
M&T Bank
BNY Mellon
Charles Schwab Bank
Other
Which of the following automobile brands do you currently own/lease
Buick
Chrysler
Dodge
Ford
Cadillac
Chevrolet
GMC
Honda
Jeep
Tesla
Acura
Audi
Bentley Motors Limited
BMW
Fisher Automotive
Genesis Motor
Lucid Motors
Toyota
Alfa Romeo
Aston Martin
General Motors
Lexus
Lincoln
Hyundai
Porsha
Other
Who is your current phone/internet provider?
AT&T
Verizon (including Fios)
Comcast (Xfinity)
Spectrum
Cox
T-Mobile
CenturyLink
Frontier
Ooma
Nextiva
RingCentral
Zoom Phone
Google Voice
Alice (Optimum)
Mediacom
Windstream
Google Fiber
Starlink
Other
Who is your current insurance provider?
State Farm
Allstate
Geico
Progressive
Nationwide
Travelers
USAA
Amica
Erie Insurance
Chubb
Farmers
America Family
Other
To prove you are a human, please provide an incorrect answer to this equation 2+3
*
What destinations are you likely to travel to within the next 18 months
Local
Continental US
Elsewhere in North America
Caribbean
Europe
Asia
South America
Other
In the past 12 months, which of the following magazines/publications have you purchased?
Time
Newsweek
The New Yorker
The Week
Rolling Stone
People
Cosmopolitan
Vanity Fair
Other
How long ago did your amputation occur?
Less than 6 months
6 months - 1 year
1 - 5 years
5 -10 years
What was the primary cause of your amputation?
Trauma/Accident
Disease (e.g., diabetes, vascular disease)
Cancer
Congenital
Other
Email (This email address is intended for private use ONLY and it will not be sold or distributed)
*
example@example.com
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