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* 1. How old are you?

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* 2. Number of years in your current organization and role?

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* 3. If you are working internationally, how long have you been in your current location? (country/city)

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* 4. Please provide some family information: Name of spouse, children's name and ages, # of children at home

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* 5. Do you have medical insurance?

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* 6. How often do you access medical check-ups, vision care, dental care, etc.

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* 7. Do you, your spouse, kids or parents have health concerns that impact you?

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