* 1. Please indicate whether you are a:

* 2. Your gender is:

* 3. What is your age?

* 4. What is your ethnicity? (Please select all that apply.)

* 5. Do you have health insurance?

* 6. Do you know where Student Health Services is located?

* 7. Have you visited Student Health Services in the past 6 months? If no, please indicate why not. (Choose all that apply.)

* 8. Have you visited Student Health Services' website?

* 9. Would you recommend Cabrillo's Student Health Services to your friends as a source of health care?

* 10. Do you know what services Student Health Services provides? Check all that apply.

T