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* 1. Are you working?

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* 2. Tell us about your home life

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* 3. What’s your home work situation like?

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* 4. What scares you most right now? Please rank in order, 1 being what scares you the most and 9 being what scares you the least.

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* 5. What kind of support or content do you need more of? (Check 3)

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