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What is your gender?
 
Female
 
Male
 
Not disclosed
 
 
 
What is your age (in years)?
   
 
 
 
Please specify your ethnicity
 
White
 
Hispanic or Latino
 
Black or African American
 
Native American or American Indian
 
Asian / Pacific Islander
 
Other
 
 
 
What is the highest degree or level of school you have completed?
 
Some high school, no diploma
 
High school graduate, diploma or the equivalent
 
Bachelor’s degree
 
Master’s degree
 
Professional degree
 
Doctorate degree
 
 
 
Do you have any comments/suggestions on the topic raised in this survey?
   
 
 
 
Do you wish to receive a summary of the results of this survey?
 
Yes
 
No
 
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