BIG Long & Proud Party Sexual Health Survey

Demographics

In order to protect your confidentiality this survey uses a unique identifier rather than your name. The information from the survey will be used by HELP to develop better HIV prevention programming for the gay community. After completing the survey you will be automatically re-directed to a website where you can print your free ticket to the BIG Long & Proud Party!

BIG Long & Proud Party
Saturday, June 21st 9pm-2am
1010 Collins Entertainment Center
(across from Cowboys Stadium)

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* 1. What day of the month were you born? (ie the 17th)

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* 2. What is your middle initial? (Of None, answer "Z")

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* 3. What year were you born?

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* 4. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 5. What is your ethnicity? (Please select all that apply.)

American Indian or Alaskan Native

Asian or Pacific Islander

Black or African American

Hispanic or Latino

White / Caucasian

Prefer not to answer

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* 6. What is your gender?

Male

Female

MtF

FtM

Other (please specify)

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* 7. How do you define your sexual orientation?

Gay

Straight

Other (please specify)