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* 1. Please indicate whether you are a:

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* 2. Your gender is:

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* 3. What is your age?

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

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* 5. Do you have health insurance?

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

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

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

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

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

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