* 1. What is your gender identity?

* 2. How old are you?

* 3. Which of the following best represents your race? (Check All That Apply)

* 4. What is your average yearly gross income?

* 5. Do you work full time, part time or are unemployed?

* 6. Where are you located?

* 7. When was the last time you saw a doctor?

* 8. Do you have a primary care physician?

* 9. If you have a primary care physician, what is the name of your primary care physician?

* 10. If you do not have a primary care physician, where do you go for healthcare?

* 11. Do you have access to a mental healthcare provider?

* 12. Would you benefit from a free mental healthcare provider?

* 13. Do you know about free mental healthcare in Columbia? (if not please contact: Integrative Behavioral Health Clinic at 5738822428 or Psychological Services Center at 5738824677)

* 14. How important is it for you to have a trans friendly provider?

* 15. Are you more likely to access a doctor who is trans friendly?

* 16. Have you ever not gone to a doctor because you could not access a trans friendly provider?

* 17. Besides not being trans friendly, what other things keep you from seeing a doctor?

* 18. Have you tried to access healthcare from MedZou?

* 19. Have you ever been turned away from access to trans healthcare?

* 20. Are you currently on Hormone replacement therapy (HRT)?

* 21. Have you been on HRT in the past and had to stop due to lack of healthcare?

* 22. Have you ever been to a doctor you thought was trans friendly, but was not when you saw them?

* 23. Do you want to be on HRT but are not due to lack of access to a trans friendly provider?

* 24. Do you have health insurance?

* 25. Does your health insurance cover trans healthcare?

* 26. Would you take advantage of a weekly free clinic?

* 27. What is the amount of time you had to wait for your first trans healthcare appointment between making the appointment and seeing the doctor?

* 28. What could a healthcare provider do to be more trans friendly and make you more comfortable with seeing them?

* 29. Is your support system family based, friend based, or self based?

* 30. Is there anything about The Center Project that you do not find affirming?

* 31. In response to the above question, if there is anything that you do not find affirming at TCP, what can be done/changed to help TCP feel more affirming?

* 32. Does The Center Project have adequate programming?

* 33. Do you have any ideas for programming at The Center Project?

* 34. Have you ever called any suicide prevention service?

* 35. Is there anyone you would like to see TCP partner with?

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