Introduction and Informed Consent

The purpose of this survey is to learn about the needs of Native youth ages 13 to 17 years old in the Fresno community. To participate in this survey, you must be American Indian/Alaska Native ages 13 to 17 living in the Fresno, Madera, Kings, and Tulare counties.

This survey is confidential which means that we will not know what your answers were. The survey will ask you questions like, “What do you see in the community that needs improvement and what are your thoughts?"

At the end of the survey you will be given the chance to enter into a drawing to win  1 of 5 prize bundles that we will raffle in early January. You will be prompted at the end of the survey to click on a google form link to enter your contact information. By using this link, the information is not tied to your survey responses. 
You will need your parent or guardian permission to complete the survey and will need to use your parent or guardian's name to enter the raffle. 
Some of the questions in this survey may be sensitive for you or may create some uncomfortable feelings.
For example, there are questions that ask about experiences that you or your friends might have had, including bullying or violence in the community. After taking this survey if you feel you need to talk to someone there will be resources and phone numbers provided for you at the end.
The information you share will tell us more about what Native youth are facing so that we can make programs and services better to support youth in the area.
This survey is completely voluntary and you can stop at any time. Depending on how you answer questions, the survey should take you about 20 minutes to complete.
If you have questions about this survey, please contact Rachel Ramirez, Director of Youth Services, Fresno American Indian Health Project by phone (5593200490) or by email at
Thank you in advance for your participation!

Question Title

* 1. By marking "yes", I consent that I am a Native youth aged 13-17 that lives in the Fresno area and also have my parental/guardian consent to participate in the survey.