Screen Reader Mode Icon
This interest survey is for our cohort beginning March 3rd, 2026. Thank you for your interest in LEAD Health Advocacy, Mazzoni Center's health and wellness educational group for LGBTQ+ and questioning youth! Participants who complete the program will receive a $100 gift card. Please fill out the survey below and we will be in contact soon.
We are only able to accept 8 people per cohort. If we fill up on spots for this first cohort, you will be contacted when we are planning for the next one.

Question Title

* 1. Please enter your contact information so we can reach out to you. We primarily communicate via Email.
We will not share this information.

Question Title

* 2. Do you identify as LGBTQ+ or questioning?
**This group is for folks that identify as LGBTQ+ or are questioning**

Question Title

* 3. Are you between the ages of 18-24?
** This group is only for folks in that age range.

Question Title

* 4. Are you based in Philadelphia or the surrounding area?
**This group meets in person in Philadelphia**

Question Title

* 5. Do you have any barriers to attending all 8 sessions?

Question Title

* 6. Where did you hear about this group?

Question Title

* 7. Do you have access to transportation to get to center city?

Question Title

* 8. Do you have any allergies or dietary restrictions?
** We are working to provide snacks/food at all meetings. We will do our best to accommodate everyone's dietary needs.

Question Title

* 9. Do you have any accommodation needs we should know of?
Ex. Need larger fonts, need a scent free space, etc.

0 of 9 answered
 

T