• Date of Birth*
     - -
  • What is your connection to the O+ Festival?*
  • Do you currently have health insurance? (your insurance status does not impact your access to the O+ Exchange clinic or Festival Clinic)*
  • What kind of insurance do you have?*
  • How did you first hear about the O+ Festival?*

  • Self-identity section
    As with all the questions on this form, we are asking for this demographic information specifically for grant writing/reporting purposes.

  • Sexual Orientation*
  • Race*
  • Do you have a home base?*
  • Should be Empty: