Race & Ethnicity
American Indian or Alaska Native
Asian or Asian American
Black or African American
Hispanic or Latino/a/x
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White or European American
Multiracial or Mixed Heritage
Prefer not to Answer
Other
Primary Language
English is my primary language
Spanish is my primary language
I am bilingual (English & Spanish)
I speak another language at home
Prefer not to Answer
Other
Gender Identity
Woman
Man
Non-binary
Genderqueer or Gender-fluid
Transgender
Agender
Two-Spirit
Prefer not to Answer
Other
Age
18 – 24
25 – 34
35 – 44
45 – 54
55 – 64
65 – 74
75 or older
Prefer not to answer
Financial Situation
Living paycheck to paycheck
Getting by, but with little left over
Comfortable, with some savings or cushion
Financially secure or thriving
Prefer not to answer
Mental Health & Emotional Wellbeing
I live with a mental health condition (such as depression, anxiety, or PTSD)
I live with a substance use history or am in recovery
I do not identify with any of the above
Prefer not to answer
Other
Mobility & Accessibility
I use a wheelchair or scooter
I use a cane, walker, or other mobility aid
I have a visual impairment
I have a hearing impairment
I have a cognitive or learning difference
I have a chronic illness or pain condition
Other
Mobility & Accessibility
I use a wheelchair, scooter, cane, walker, or other mobility aid
I have a visual impairment
I have a hearing impairment
I have a cognitive or learning difference
I have a chronic illness or pain condition
Other
Mobility & Accessibility
I use a wheelchair or scooter
I use a cane, walker, or other mobility aid
I have a visual impairment
I have a hearing impairment
I have a cognitive or learning difference
I have a chronic illness or pain condition
Other
Do you need any accommodations to fully participate?
Yes
No
Not sure yet
Prefer not to answer
Please describe
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