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Please take 20 minutes to complete this survey. Your participation will help us improve our health in our pueblo. Thank you!

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* 1. What is your age?

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* 2. What gender do you most identify as?

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* 3. How many children under the age of 18 live in your home?

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* 4. Do you have reliable internet access at your home?

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* 5. If you do not have reliable internet access, what other ways can our staff reach out to you and your family?

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