Cultural Bias Consulting Questionnaire (20-30 minutes)
My Cultural Bias Consulting (from the perspective and experience of a queer Black American) will have a myriad of topics that can be discussed -- including, but not limited to: microaggressions/macroaggressions, the history of policing as it pertains to neighborhoods affected by redlining, false relatability, white privilege, colorism, why you probably shouldn't wear locs/box braids/black hairstyles, anti-gay and transphobic rhetoric, and most social issues regarding religious colonization and genocide. For my personal safety and peace of mind, every potential client is required to fill out a questionnaire to assess whether or not I feel you and I will be able to move through our session(s) with the least harm done on either end.

Once I review your answers, I'll email you and tell you if you are:
- A Learner: I believe you and I are ready to have a healthy dialogue and we can move on with the next phase.
- On Waitlist: Same as the first option, but I have run out of slots for the month. I will circle back to you and contact you when more slots are open.
- Potential: I do not think you and I are ready to get into the nitty gritty quite yet, and you have a few mental blocks I believe will hinder your growth. You'll get a full explanation as to why, as well.

These are intense questions. If you find yourself being resistant to giving an honest answer -- whether it be out of shame or guilt -- and don't have any desire to challenge it, you may not be ready for these sessions. I am more than happy and willing to be patient because I realize it's impossible to understand complex and sensitive topics surrounding gender, sexuality, and race within an hour and a half. However, I do have my boundaries and I will not spend the entire session debating you or being disrespected with questions that intentionally miss the point of whatever I say. I can only teach as much as you're willing to learn.

That being said, do not feel pressured to perform your answers for me! The foundation of this service is raw honesty and trust to grow. We all had to start from somewhere -- even me. There is never shame in actively learning and trying to understand something foreign to you. Never. Don't feel pressured to write entire essays to explain yourself, either. Write as much or as little as you want.

Note: Because I do not live as a trans person, I feel like it is not my place to give out in-depth education on the topic. I can help you understand it as a surface level, but I highly recommend going to someone that lives as a trans person to help you understand more. If you need resources, please feel free to send me a DM on social media or email me.
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Email *
BACKGROUND INFO
This section is just to get a general feel for who you are.
Name *
First and last name
Pronouns *
Required
Please type today's date: *
Are you a part of the LGBTQIA+ community? (the A stands for asexual, not ally.) *
Nationality (country of origin) *
Racial background *
What aspect of this service do you want to learn about? What do you hope to gain by learning from me? *
Do you come from a religious background? If yes, which path? *
Do you find yourself to be more progressive, conservative, central, or uninvolved in your political beliefs? *
Do you tend to avoid conflict to keep the peace, or are you comfortable with confrontation? *
Do you find it difficult to change your mind about a topic while learning about it? Do you feel a resistance when it comes to accepting something? *
Optional: Tell me a little more about yourself, past the systemic labels.
OPINION AND SHORT ANSWER
Answer these questions as honestly as possible with your own genuine opinion. I cannot stress enough that you will not be judged harshly, especially if the main reason you're here in the first place is because you WANT to learn. Feel free to take your time and think about what you wanna say.

If a question does not pertain to the reason that you're seeking this service (ex. you want to learn about racial microaggressions and don't need to answer any of the LGBTQIA+ related answers), just put N/A.
Can you summarize your feelings on the concept of white privilege? *
Can Black people be racist? *
What does the Confederate flag symbolize to you? *
How do you feel about the current state of the police in the US? (if you're not from the US or don't live in the US, feel free to skip this question) *
Do you agree with the Land Back movement? *
How do you interpret the Black Lives Matter movement? *
Pertaining to George Floyd: was the outcry a riot, a protest, or something else? Do you think the police were justified in their actions? *
Do you believe kids are being harmed by being raised in a family with two LGBTQIA+ parents? *
How were you taught to view members of the LGBTQIA+ community? Does this reflect your current views? Feel free to be specific (ex. being gay but not believing in bisexuality, religion dictates your views, being queer but having uninformed views on trans and non-binary people, etc.) *
Tell me about your views on trans people. *
Do you believe being LGBTQIA+ is an active choice? *
PAYMENT AND BUDGET
If you are accepted for this month's slot, would you be able to pay the fee in full or would you need a payment plan? *
Do you plan on purchasing more than one session? *
A copy of your responses will be emailed to the address you provided.
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