Detroit Mama Survey

This survey is for moms-to-be and moms who have had a baby in the last 5 years. The information gathered from this survey will be helpful in developing a mom/family wellness center in the city of Detroit. Please read the questions carefully and respond thoughtfully. Your responses are anonymous. Thank You!

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* 1. Where do you live? Please enter your ZIP code.

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* 2. What is your age?

Under 21

21-25

26-30

31-35

36-40

41-45

Over 45

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* 3. Which describes your work?

Full-time

Part-time

Stay-at-home mom

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* 4. What is your household income?

Less than $20,000

$20,000 to $34,999

$35,000 to $49,999

$50,000 to $74,999

$75,000 to $99,999

$100,000 to $149,999

$150,000 to $199,999

$200,000 or more

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* 5. What is your highest educational level achieved?

High school diploma or GED

Some College

Bachelor's degree

Master's degree

Doctorate degree