2010 Florida Ryan White Anonymous Needs Survey

Introduction

If you have HIV/AIDS, this is your chance to tell us what services YOU need. Your answers will help your local Planning Group decide how funding is used in your area for HIV services.

Some questions are personal. We have to ask them to know how best to help you. All the answers will be combined so no one will be able to identify you.

Please tell your friends about this survey. We want to hear from as many people who are living with HIV/AIDS as we can.

If you take care of someone who cannot fill out the survey alone, please help them.

If you have completed this survey in the past 12 months, do not respond again.

Your area may have a different form of this survey. Please choose the county that you live in from the list below. If you get a message that a local survey is available, please follow the directions and do NOT complete this survey.
County:

Your area may have a different form of this survey. Please choose the county that you live in from the list below. If you get a message that a local survey is available, please follow the directions and do NOT complete this survey. County:

Other (please specify)

Introduction

Your area may have a different form of this survey. Please choose the county that you live in from the list below. If you get a message that a local survey is available, please follow the directions and do NOT complete this survey.County:

Your area may have a different form of this survey. Please choose the county that you live in from the list below. If you get a message that a local survey is available, please follow the directions and do NOT complete this survey.
County: