LGBT Health Care Experiences

 
We appreciate your willingness to complete this short survey to help us better understand the healthcare experiences and cancer awareness of the LGBTQ population in the greater Sacramento region. To be eligible to take the survey, you need to be 18 years of age or older, self-identified as LGBTQ, and living in the greater Sacramento region. The survey should take 5-10 minutes to complete. Please answer each question. You may opt out of the survey at any time. Thank you so much.
1. Which category below includes your age?
2. What is your current gender identity?
3. What sex were you assigned at birth?
4. With what ethnicity/race do you identify?
5. What was the highest grade or year of school you completed?
6. Would you prefer that your sexual orientation and gender identity be included in your medical record?
7. What is your approximate average household income?
8. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)
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