"Unforgettable" Survey

Thank you for participating in this brief survey. This survey will take approximately 5 minutes to complete. Responses will be kept confidential and findings will be presented on a group-level. Responses collected in this survey will help to continue to improve education, programs, and services to meet the needs of caregivers and the individuals that are receiving care.

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* 1. What is your age?

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* 2. What is your gender?

Female

Male

Transgender man

Transgender woman

Nonbinary

Gender nonconforming

Prefer not to answer

Self describe

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* 3. What is your race?

White/Caucasion

American Indian/Alaska Native

Asian

Black/African American

Hispanic/Latino

Native Hawaiian/other Pacific Islander

Two or more races or ethnicities

Prefer not to answer

Other race or ethnicity (please specify)

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* 4. What city did you see Unforgettable in?

Miami, FL

Indianapolis, IN

Milwaukee, WI

Pittsburgh, PA

St. Louis, MO

Cleveland, OH

Atlanta, GA

Oakland, CA