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Eligibility Questionnaire

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* 1. Do you have Chinese ancestry/heritage?

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* 2. What is your age?

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* 3. What is your gender?

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* 4. What is your current immigration status?

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* 5. Where do you live?

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* 6. Have you faced any difficult problem that was hard to solve since living in Canada?

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* 7. Please specify the areas of the problem you experienced (select all that apply):

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* 8. When did the most recent issue start?

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* 9. What type of interview are you available for?

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* 10. Do you have any accessibility needs for the interview (audio/visual assistance, ramps, etc.)? (please specify)

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* 11. Last name:

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* 12. First name

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* 13. Your email address:

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* 14. What is your home address? (Street)

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* 15. City:

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* 16. Province:

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* 17. Postal / Zip Code:

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* 18. Your phone number:

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* 19. Do you need an interpreter for the interview?

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