CDPHE Content Messaging Workgroup Survey

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Thank you for your interest in serving on one of our content messaging workgroups! We are looking to establish a group of people who will help us deliver accurate health information to young folks like you. If you would like to volunteer to spread the word and take charge of your sexual health, please fill out the questions below. Your voice is instrumental in creating a sex-positive Colorado!

The information collected in this survey is for CDPHE use ONLY. It will not be shared with other organizations.

**Please note that participation in the workgroups is voluntary. However, $20 gift cards will be provided for your time!**

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E-Mail-Adresse *

Phone number to receive workgroup reminders via SMS?

What is your preferred first & last name? *

Which of the following is the best way to inform you of meeting dates, new campaigns for review, etc.? *

Text message

Sonstiges:

In which county do you live in? *

How do you describe your gender identity? *

Female - cisgender

Male - cisgender

Transgender, Female-to-Male

Transgender, Male-to-Female

Non-Binary / Gender non-conforming

Genderqueer/Genderfluid

Agender

Gender identity not listed or decline to answer

How do you describe your sexual orientation? *

Gay / Lesbian / Homosexual

Straight / Heterosexual

Pansexual

Bisexual

Asexual

Queer

Unsure

Sexual orientation not listed or decline to answer

What is your age? *

17 or younger

18-20

21-29

30-39

40 or older

Which of the following describes your race? Select all that apply. *

White

Black or African American

American Indian or Alaskan Native

Asian

Native Hawaiian or other Pacific islander

From multiple races

Another race not specified here

Pflichtfrage

What is the highest level of school you have completed or the highest degree you have received? *

Less than high school degree

High school degree or equivalent (e.g., GED)

Some college but no degree

Associate degree

Bachelors degree

Graduate degree

Is there any important information you feel we should know about you? (e.g., identities, interests, passions, hobbies etc. )

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Dieses Formular wurde bei State.co.us Executive Branch erstellt.

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