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Siyan - Needs Assessment Survey - Sonoma County 2026
Please complete this anonymous survey to help Siyan Clinical Research (SCR) to improve services and to identify gaps in care in Sonoma County. Thank you for your time and opinion!
1.
What is the zip code where you live?
2.
Please select the option(s) that most closely apply to you.
I am a behavioral health client (current or past) with Siyan or another agency
I am the parent, caregiver, friend, or family member of a behavioral health client (current or past) with Siyan or another agency
I am a community member
In my work role, I provide services to people in the community
Other
If Other (please specify)
3.
What is your gender?
Male
Female
Prefer not to say
4.
What is your preferred language?
English
Spanish
Other
Other (please specify)
5.
Are you a Veteran of the US Armed Forces?
Yes
No
6.
What is your age?
0-17 years old
18-25 years old
26-45 years old
46-55 years old
56-64 years old
65 years old or older
7.
What is your race/ethnicity?
Asian
Black/African American
Hispanic/Latino
Native American
White
Other
If Other (please specify)
