Civil Discourse in Action: A Health Care Reform Dialogue

Thanks for your interest in this forum.  We greatly appreciate you filling out this survey so that we may find participants with diverse backgrounds who live in Washington's 8th Congressional District.   The forum is planned for Saturday, March 31, for 10:00 AM-12:30 PM in Downtown. Issaquah.

Contact Information 

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* 1. Contact Information 

What is your gender?

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* 2. What is your gender?

What is your age?

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* 3. What is your age?

Which race/ethnicity best describes you? (Please choose only one.)

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* 4. Which race/ethnicity best describes you? (Please choose only one.)

In general, how would you describe your views on most political issues? Are you:

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* 5. In general, how would you describe your views on most political issues? Are you:

How would you describe your income category?

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* 6. How would you describe your income category?

Do you have any other comments, questions, or concerns?

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* 7. Do you have any other comments, questions, or concerns?

How did you find out about this event?

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* 8. How did you find out about this event?

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