Survey on LGBTQIA+ Older Adults in California: From Challenges to Resilience - Statewide Coalition Registration

Join Our Coalition!

The study requires participation from a coalition of state agencies, LGBTQ+ service providers, and organizations serving older adults. Coalition members will facilitate communication to the LGBTQ+ community in their state region, serving as trusted outlets for eligible participants. All information provided will remain confidential.

California is poised to conduct its first baseline study on the aging experience of LGBTQ Californians. Openhouse is coalescing a coalition - alongside researchers from UC Berkeley's CITRIS & Banatao Institute, the California Department of Aging - of statewide LGBTQ organizations and centers, service providers, aging agencies, and other community stakeholders to aid in spreading awareness and executing the survey. The survey will formally go live January 8th, 2024, and will close March 31st, 2024 - with a targeted goal of releasing an open-source executive summary report by Pride Month 2024. The goal is 2,000 responses.

Please complete the questions below to join our statewide coalition of stakeholders.

For any questions or concerns, please email Jupiter Peraza at jperaza@openhousesf.org

Question Title

* 1. Name of the LGBTQ organization, center, or entity you represent.

Question Title

* 2. What is the organization subject type?

LGBTQ Non-Profit Organization

LGBTQ Center

Aging Agency

Long-Term Care

Other (please specify)

Question Title

* 3. Are you located on Northern, Central, or Southern California?

Northern

Central

Southern

Question Title

* 4. **Name the city and county where you are located. (City, County)**

Question Title

* 5. **Website of the LGBTQ organization, center, or entity you represent. (If no website exists, please input N/A).**

Question Title

* 6. **Point of contact for the LGBTQ organization, center, or entity. (Full name, email, and phone number).**

Name

Email Address

Phone Number

Question Title

* 7. **Select the services provided by the organization, center, or entity aforementioned. Select all that apply.**

Housing

Health

Economic and Workforce Development

Immigration

Community Building/Peer Support

Palliative Care

Food Insecurity

Financial (stipends, income support, etc.)

Other (please specify)

Question Title

* 8. **Select the languages the organization, center, or entity aforementioned, provides services in. Select all that apply.**

English

Spanish

Tagalog

Chinese

Vietnamese

Other (please specify)

Survey on LGBTQIA+ Older Adults in California: From Challenges to Resilience - Statewide Coalition Registration

Join Our Coalition!

Question Title

* 1. Name of the LGBTQ organization, center, or entity you represent.

Question Title

* 2. What is the organization subject type?

Question Title

* 3. Are you located on Northern, Central, or Southern California?

Question Title

* 4. Name the city and county where you are located. (City, County)

Question Title

* 5. Website of the LGBTQ organization, center, or entity you represent. (If no website exists, please input N/A).

Question Title

* 6. Point of contact for the LGBTQ organization, center, or entity. (Full name, email, and phone number).

Question Title

* 7. Select the services provided by the organization, center, or entity aforementioned. Select all that apply.

Question Title

* 8. Select the languages the organization, center, or entity aforementioned, provides services in. Select all that apply.

* 4. **Name the city and county where you are located. (City, County)**

* 5. **Website of the LGBTQ organization, center, or entity you represent. (If no website exists, please input N/A).**

* 6. **Point of contact for the LGBTQ organization, center, or entity. (Full name, email, and phone number).**

* 7. **Select the services provided by the organization, center, or entity aforementioned. Select all that apply.**

* 8. **Select the languages the organization, center, or entity aforementioned, provides services in. Select all that apply.**