1. Default Section

* 1. Name (optional)

* 2. Are you...? (select all that apply)

* 3. City, State

* 4. Race/Ethnicity

* 5. Gender

* 6. Are you a member of the National Latino AIDS Action Network (NLAAN)?

* 7. Would you like to become a member of NLAAN? If you answered yes, please provide your email address.

* 8. Please select YOUR TOP 3 CHOICES regarding additional information you would be interested in receiving about NLAAN.

* 9. How familiar are you with the Affordable Care Act, also known as the Health Care Reform Law?

* 10. How would you best describe the Affordable Care Act's impact on the Latinos in your community?

* 11. How has the economic recession affected your organization and its ability to target outreach and prevention to Latinos?

* 12. How has the recession impacted your agency's or organization's ability to serve the Latino population?

* 13. Thinking back one year, how many Latino clients are you able to serve now compared to a year ago?

* 14. From whom do you receive funding? (please select all that apply)

* 15. Under each of these categories please check how the funding amounts have reacted to the present economic climate.

  Less More Same Not applicable
State Funding
County Funding
Private Foundation funding

* 16. Please select your TOP 3 CONCERNS about how the Affordable Care Act will directly impact Latinos in your community?

* 17. How familiar are you with the National HIV/AIDS Strategy?

* 18. How would you best describe the National HIV/AIDS Strategy's potential impact on Latinos in your community?

* 19. Please select your TOP 3 CONCERNS about how the National HIV/AIDS Strategy will impact Latinos in your community?

* 20. In your opinion, what should THE TOP 3 priorities be for the development of the 2011 Latino/Hispanic HIV/AIDS Federal Policy Recommendations?

* 21. How many Latinos received services from your organization in the last year?

* 22. Does your organization provide services to undocumented immigrants?

* 23. If you answered NO; is it because of restrictions with State and/or local laws?

* 24. What is the percentage that most accurately resembles the proportion of Latinos served by your organization in comparison to the total population served?

* 25. How many undocumented immigrants did your organization serve last year? (estimate)