JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2021/2022 Student Health and Counseling Center Student Survey
July 2021 - June 2022
Sign in to Google
to save your progress.
Learn more
* Indicates required question
What year are you? Select one.
*
First Year
Sophomore
Junior
Senior
Graduate
Did you transfer to WOU?
*
Yes
No
What is your gender identity? (optional)
Male
Female
Transgender
Non-binary/third gender
Prefer to self-describe
Other:
What is your sexual orientation? (optional)
Heterosexual
Gay
Lesbian
Bisexual
Pansexual
Prefer to self-describe
Other:
Clear selection
Which describes your racial or ethnic identity? Select all that apply.
*
American Indian or Alaska Native
Asian
Black or African American
Middle Eastern
Native Hawaiian or Pacific Islander
White
Unknown
Decline to answer
Other:
Required
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Western Oregon University.
Report Abuse
Forms
