SOMOSLOUD Community Engagement Survey

Community Engagement

By learning more about you, what works well and what doesn't, we're empowered to make decisions that better serve our communities. Your input is invaluable—thank you for sharing your voice!
Name

First NameLast Name
Email*
example@example.com
Phone Number

Country CodeArea CodePhone Number
Are you 21+

YesNo
Age Range

20-2930-3940-4950-59>60+
Where do you live?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Where do you live?
City, State
How did you hear about this event?

Social media (Instagram)Word of mouthEventbriteOther (please specify)
Have you attended a SOMOSLOUD event in the past?

YesNo
Are you part of a local group/ organization?

NoIf Yes, (Title & Organization)
How do you identify ethnically or culturally??

Latina/LatinoLatinxLatineHispanicAfro/ LatinxIndigenous/Native AmericanWhiteBlack/African AmericanAsian/Pacific IslanderPrefer not to sayOther
What is your gender identity?

MaleFemaleNon-BinaryTransgenderPrefer not to sayOther (please specify)
What is your sexual orientation?

HeterosexualGayLesbianBisexualQueerAsexualPansexualPrefer not to sayOther (please specify)
How would you rate the accessibility of immigration services for Latinx individuals in your community?

Very accessibleSomewhat accessibleNot very accessibleNot accessible at all
Have you or someone you know experienced discrimination or prejudice in housing opportunities based on Latinx identity?

YesNoNot sure
Are you aware of available resources and support systems specifically tailored for Latinx individuals living with HIV/AIDS in your area?

Yes, very awareSomewhat awareNot very awareNot aware at all
Do you know what PrEP/PEP are?

YesNoUnsure
How comfortable do you feel discussing mental health concerns within the Latinx community?

Very comfortableSomewhat comfortableNot very comfortableNot comfortable at all
How would you rate the accessibility of mental health services for Latinx individuals in your community?

Very accessibleSomewhat accessibleNot very accessibleNot accessible at all
What support or resources do you feel are lacking for Latinx individuals?

Legal assistanceMental health servicesHousing assistanceJob training and employment opportunitiesAccess to healthcareCommunity spaces and eventsOther (please specify)
What topics or activities would you like to see covered in future events?

Health and HIV/AIDS awarenessEducational workshopsCultural heritage and identityMental health and wellnessArts and culture showcasesLGBTQ+ rights advocacyNetworking opportunitiesImmigration ResourcesOther (please specify)
Would you be interested in receiving updates about upcoming events and our activities in the future?

YesNo
Would you be interested in volunteering or getting involved with our organization in the future?

YesNoMaybe
Any additional comments or questions?

YesNo
Comments/Questions
SOMOSLOUD - Latino Outreach & Understanding Division

SOMOSLOUD is a volunteer-based advocacy group of AHF (AIDS Healthcare Foundation). We're powered by volunteers and fueled by innovative events/campaigns that shed light on Latinx issues.

Keep in touch!

Follow our main page at @somosloud or

any of your local chapter pages @somosloud_[insert cityname]
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