1. Demographics

 
13% of survey complete.

Information about you:

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* 1. In terms of your sex/gender how do you identify?
(please select all that apply)

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* 2. Sexuality:

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* 3. What is your postal code?

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* 4. What is your age group

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* 5. How long have you been using programs and services at Women's Health in Women's Hands CHC

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* 6. Which of the following groups would you use to identify yourself?

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* 7. Please indicate the language(s) you are able to use.

  Speaking Reading Writing
English
French
Spanish
Swahili
Somali
Amharic
Hindi
Urdu
Punjabi
Arabic
Portuguese
Italian
Other

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* 8. What was your family's total income last year?

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* 9. What is your religion?

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* 10. What role does religion play in your daily life?

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* 11. Please specify any way we can better accommodate your religious or faith-based needs?

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* 12. How many people in your household are supported by this income?

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