Minnesota Health Insurance Exchange Sample Module Feedback Survey

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1. Please self-identify yourself. This information will be used solely to help us determine that the responses gathered represent a broad spectrum of the population. (select all that apply)
Please share information on yourself. This information will be used solely to help us determine if we are gathering responses from the widest mix of the population.
2. Age:
3. Gender:
4. Geographic Location:
5. Ethnicity:
6. Race:
7. Annual Household Income:
8. Highest Education Level: