Counseling Center/PRT Community Stakeholder Survey Question Title * 1. Are you aware of what programs our Counseling Center campus offers? Yes No Question Title * 2. What is your zipcode Question Title * 3. Age Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 4. Which gender do you identify most with Male Female Prefer not to say Question Title * 5. What barriers if any prevent you or your loved ones from seeking or receiving care? Lack of transportation Concerns with privacy Unaware of services offered Scheduling conflict Unsure if I would benefit from services None of the above Other (please specify) Question Title * 6. Are you or someone you know experiencing addiction? Yes No Other (please specify) Question Title * 7. In general, how would you rate your overall mental or emotional health? Excellent Very good Good Fair Poor Question Title * 8. When did you last get your mental health examination done? Currently seeing a mental health professional less than 6 months Within the last year Over a year Never Other (please specify) Question Title * 9. What is your tribal affiliation? Osage Cherokee Ponca Pawnee Quapaw Creek Non- Native Other (please specify) Question Title * 10. Living Status? Homeowner Renter Living with Family Temporary Housing Homeless Prefer not to say Done