JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Pre-Conversation Input - The Great Reset
You are part of a larger group of people through the country taking part in The Great Reset.
The key pillars of The Great Reset are to have conversations that afford the opportunity to share with humility and listen with respect. There is no agenda. The intention is to empower everyone to engage in conversation.
These surveys are intended to help us build better conversations and make them more compelling to people. We believe the more people talking, and the more people willing to listen leads to better and stronger communities.
Again, thank you for taking part in the conversation. Your participation is imperative to bring us all just a bit closer together.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Date of upcoming conversation (if you are not going to be participating in a conversation fill in with the first day of the current month and year)
*
MM
/
DD
/
YYYY
Location
*
Choose
AL
Ak
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Canada
Other
Your gender:
*
Choose
Male
Female
Other
Prefer not to answer
Your age:
Under 18
18-24
25-34
35-44
45-54
55-64
65-80
Over 80
The topic this month is Mental Healthcare . How comfortable do you feel talking about this topic? 1= not at all and 5= very comfortable
*
1
2
3
4
5
Do you feel Mental Healthcare is stigmatized?
*
Not at all
1
2
3
4
5
Absolutely
How is the United States doing managing Mental Healthcare
*
Not well at all
1
2
3
4
5
Very well
Please elaborate, on your previous response, regarding how well the United States is doing managing Mental Healthcare.
Your answer
Is it best to manage Mental Healthcare proactively or reactively? Note scale 1= proactively and 5= reactively
*
Proactively
1
2
3
4
5
Reactively
Regarding your previous answer, why do you feel it's best to manage Mental Healthcare in that way (either proactively or reactively)?
Your answer
Is Mental Healthcare a right, or a privilege?
*
Right
Privilege
Depends (if depends, please elaborate next)
Required
If you answered 'depends' to 'Is Mental Healthcare a right or a privilege', please elaborate, otherwise skip.
Your answer
Should Mental Healthcare be covered for all?
*
Choose
No, that should be on the individual
Yes, because the whole of society benefits from good mental healthcare for all
It depends (please elaborate following)
If you answered, 'it depends' to 'Should Mental Healthcare be covered for all', please elaborate.
Your answer
Which of the following topics interest you most for future conversations? Choose all that apply
*
Immigration
Preparing for the future - Educating America
The road to happiness
Nationalism
The Middle Class - Economics and Democracy
Gender roles and expectations
Discrimination and power in America
'The Wall'
Marijuana legalization
The Puritan Ethic
Race relations
Women's rights
Guns in America
Other:
Required
When was the last time you had a deep conversation, about a relevant topic, with someone of a very different opinion?
I can't recall
1
2
3
4
5
Frequently
Clear selection
Any additional comments about The Great Reset?
Your answer
Is there anyone, other than you, you think would like to participate in The Great Reset? (If yes, name, email and phone - if no, please leave blank)
Your answer
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
