Centers for Disease Control and Prevention (CDC) funded prevention survey designed by Arizonans for Arizonans.

This prevention survey is funded by a CDC program designed by Arizonans for Arizonans. The data will be used to guide targeted prevention programs throughout the state to help Arizonans live a more healthy life. The data gathered through this survey is completely confidential.

Question Title

* 1. What is your race / ethnicity?

White

Black or African-American

American Indian or Alaskan Native

Asian

Hispanic / Latino

Native Hawaiian or other Pacific Islander

From multiple races

Some other race (please specify)

Question Title

* 2. What year were you born?

Question Title

* 3. What is your gender?

Male

Female

Transgender M-F

Transgender F-M

Other (please specify)

Question Title

* 4. What is the highest level of school you have completed or the highest degree you have received?

Less than high school degree

High school degree or equivalent (e.g., GED)

Some college but no degree

Associate degree

Bachelor degree

Graduate degree

Question Title

* 5. Do you currently have health insurance, or not?

Yes, I do

No, I do not

I don't know

Question Title

* 1. What is your race / ethnicity?

Question Title

* 2. What year were you born?

Question Title

* 3. What is your gender?

Question Title

* 4. What is the highest level of school you have completed or the highest degree you have received?

Question Title

* 5. Do you currently have health insurance, or not?

Question Title

* 6. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)