Let's Kick ASS Participant Survey Feburary 2014

Demographic information

Question Title

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

ZIP:

Question Title

* 2. How old are you?

<45

45-49

50-54

55-59

60-64

65-69

70-74

75-80

>80

Question Title

* 3. What is your HIV status?

HIV-

HIV+

AIDS diagnosis

I don't know