Ballroom We Care Survey

Ballroom Focused Survey

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* 1. Age

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 2. Please enter your zipcode below?

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* 3. What is your gender identity?

Female

Male

Genderqueer or Gender Nonconforming

Transgender - MtF

Transgender - FtM

Agender

Two Spirit

Not specified above, please specify

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* 4. What is your sex assigned a birth?

Male

Female

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* 5. What is your sexual orientation?

Asexual

Bisexual

Gay

Heterosexual or straight

Lesbian

Pansexual

Queer

Same Gender Loving

None of the above, please specify

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* 6. Which race/ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Afro-Latinx

Asian/Pacific Islander

Black/African-American

Hispanic

White / Caucasian

Other (please specify)

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* 7. Which Scene are you affiliated with? Please select which group below

Main Ballroom Scene

Kiki Scene

Both

No affiliation

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* 8. Do you know of resources or programs in NYC for individuals struggling with crystal meth?

Yes

Not sure

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* 9. How important are services for crystal meth in the Ballroom Community?

Extremely important

Very important

Somewhat important

Not so important

Not at all important

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* 10. Do you know anyone in the Ballroom Community who tried crystal meth?

Yes

Not sure

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* 11. Do you know anyone in the Ballroom Community who may be addicted to Crystal Meth?

Yes

Not sure

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* 12. Have you ever tried Crystal Meth?

Yes

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* 13. Do you know anyone in Ballroom whose death may have been a direct, or indirect result of crystal meth use?

Yes

Not sure

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* 14. Would you like to see more community-focused events that focus on addressing crystal meth use among Ballroom members?

Yes

Not sure

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* 15. Are you in need of any assistance or resources for yourself or a loved one struggling with crystal meth or mental health issues? If yes, please leave your email in the section below. All responses are anonymous

Yes

Email Address?