Research Form

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Your Information

Name*

First Last

Email*

Phone

Select your Account Representative*

Which party are you representing?*

Plaintiff

Defense

n/a

Corporate/ Claim Contact Information

Corporate/ Claim Contact- Applicable?

This is not applicable

Company Name

Address

Street Address Address Line 2 City State ZIP Code

Corporate/Claim Contact Name

First Last

Contact Email

Contact Phone

Billing Contact?

Yes

Bill Delivery Preference

Electronic Delivery

Standard Mail Delivery

Attorney Contact Information

If Applicable

Company Name/ Firm

Attorney Name

First Last

Attorney Title

Attorney Email

Attorney Phone

Address

Street Address Address Line 2 City State ZIP Code

Billing Contact?

Yes

Bill Delivery Preference

Electronic Delivery

Standard Mail Delivery

Research Participants

Please list the attorneys you are working with and any additional parties who are participating in the research exercise. These contacts will receive an invite to the exercise and a copy of the report/ final work product. These contacts will also be screened.

Participating Contacts

Click “Add Participant” to enter each contact individually.

Name	Firm	Email	Actions

There are no Participants.

Maximum number of participants reached.

Research Information

Case Name*

Matter/Claim #

Group Date

MM slash DD slash YYYY

Trial Date

MM slash DD slash YYYY

How long do you expect the trial to last?

City, County, State

Judicial District

Judge Name

Courthouse Name & Location

Research & Reporting Options

Please choose the group type and delivery speed below.

Group Type

Focus Group/ Mock Trial

JuryConfirm 20/20 (online jury research 4.5 hour session)

JuryConfirm 20/20+ (online jury research 7 hour session)

Amount of Deliberation Panels

Live Streaming for remote viewers?

Yes (additional fee)

How many feeds?

Presentations and one deliberation group (additional fee)

Presentation and all deliberation groups (additional fee)

Report Delivery Speed

10 business days (regular turn around)*

6-9 business day turn around (additional fee)*

3-5 business day turn around (additional fee)*

*raw data and videos available within 48 hours post session

Final Eligibility Screener

The following information will be used to create a screener to deselect potential mock jurors who may have knowledge of the case of be associated with any of the parties.

List any other important dates in the case

Plaintiff Attorneys (Names and Firms)

Plaintiff Corporate/Insurance Company if applicable

Plaintiff Parties & Additional Names (witnesses, companies, experts, etc.)

Defense Attorneys (Names and Firms)

Defense Corporate/Insurance Company if applicable

Defense Parties & Additional Names (witnesses, companies, experts, etc.)

Pre-Research Survey

What are the Issues/Themes of the case you’re looking to test?

What is the percentage of liability you estimate?

What is the amount of damages you estimate?

Please upload any additional documents, filings, briefs, summaries etc

Drop files here or

Max. file size: 50 MB.

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Case Intake Form

Your Information

Corporate/ Claim Contact Information

Attorney Contact Information

Research Participants

Research Information

Research & Reporting Options

Final Eligibility Screener

Pre-Research Survey

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