GCDD Consumer Satisfaction Survey Pre-Test

Preliminary questions for GCDD Consumer Satisfaction Survey

Your contact information will only be shared with GHF so that we can follow up with you after the presentation. Your contact information and individual responses will not be shared with any other organization or individual.

Question Title

* 1. Date

Date / Time

Date

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* 2. Location

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* 3. Host project

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* 4. Please enter your name.

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* 5. Please enter your email.

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* 6. Check all the boxes below that describe you.

I am a self-advocate.

I am a family member of a self-advocate.

I am a professional or other.

I live in Rural Georgia (outside of a city of Georgia)

I am a man

I am a woman

My gender is non-binary.

I prefer not to tell you my gender.

I am white.

I am Native Hawaiian or other Pacific Islander.

I am Asian.

I am Native American/American Indian

I am Hispanic/Latino

I am two or more races.

I am Black or African American.

I don't know my race/I choose not to tell you what my race is.

GCDD Consumer Satisfaction Survey Pre-Test

Preliminary questions for GCDD Consumer Satisfaction Survey

Question Title

* 1. Date

Question Title

* 2. Location

Question Title

* 3. Host project

Question Title

* 4. Please enter your name.

Question Title

* 5. Please enter your email.

Question Title

* 6. Check all the boxes below that describe you.

Question Title

* 7. Zoom Link