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LGBTQ+ Center Anonymous Testing Feedback
The goal of this research is to better understand who is using anonymous testing and why they chose it as we make decisions on continuing to offer testing at the LGBTQ+ Center.
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* Indicates required question
What is your age?
Younger than 18
18-24 years old.
25-34 years old.
35-44 years old.
45-54 years old.
55-64 years old.
65+
Clear selection
Do you consider yourself Hispanic/Latino/a/x?
*
Yes, Hispanic/Latino/a/x
No, Not Hispanic/Latino/a/x
Unknown
Prefer not to say
What is your racial identity?
*
American Indian or Alaska Native
Asian or Asian American
Black or African American
Native Hawaiian or Other Pacific Islander
Middle Eastern/North African
White or European American
Other
Unknown
Prefer not to say
Required
Describe Your Gender
*
Cisgender man
Cisgender woman
Man
Non-Binary
Transgender Man
Transgender Woman
Woman
Don't know
Not Listed
Assigned Sex at Birth
*
Intersex
Female
Male
Prefer not to say
Sexual Orientation
*
Bisexual
Gay
Heterosexual/Straight
Lesbian
Pansexual
Queer
Not Listed
I don't know
Prefer not to say
If you would like, feel free to elaborate on your sexual orientation so that we may better provide care for you.
Your answer
Your Zip Code
*
Your answer
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