Chicago Health Text - Reader Interest Survey
We are interested in learning more about our readers so that we can better serve you. We also request your feedback on a new text messaging service in development. Chicago Health Text aims to empower Chicago residents in underserved communities by increasing access to health data, news and resources provided by independent media. Read more about the initiative at www.chihealthtext.org

The survey will only take a few minutes of your time, and you could win one of four Amazon gift cards! The survey will be open until October 31, 2021.


Sign in to Google to save your progress. Learn more
What is your email address? This will only be used to notify you if you are a gift card winner.
What is your zip code? *
Race? Select all that apply
Do you identify as Hispanic/Latino?
Clear selection
What language do you prefer to receive written news or information? *
Number of children under age 25 that live with you? *
What are your primary sources of local news? Select all that apply *
Required
If applicable, which publications?
If applicable, which app or online newsletter?
Where do you primarily get information about music/band concerts in Chicago?
Clear selection
What content do you seek in terms of local news? *
Select all that apply
Required
What content do you feel is missing or you would like to see more of from your local news sources? *
What health and well-being topics are you interested in? *
Required
Would you like to ask questions of reporters and receive information regarding health and well-being via text messaging? *
Would you be interested in participating in a trial of this new text-messaging service? *
First Name *
Please enter your email address if interested in participating and we will email you when the service is ready.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms