* 1. Are you a parent?

* 2. If you are a parent, how old is your child/children? Check all that apply.

* 3. Did your child/children have health insurance in 2014?

* 4. Why is health insurance important for your family?

* 5. If you were told that Congress could cut a health insurance program that covers your child/children, how would that impact your family?

* 6. If you were told that Congress could cut a health insurance program that covers your friend or relative’s child/children, how do you think that would impact them?

* 7. Can we contact you to learn more about your experience?

* 8. Please enter your contact information below.

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