Pre-assessment Quiz
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- Question 1 of 17
1. Question
Which of the following best describes the area you live in?
- Question 2 of 17
2. Question
What is your gender identity?
- Question 3 of 17
3. Question
If you selected Other for your gender identify please, specify, otherwise enter NA:
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
- Question 4 of 17
4. Question
What is your sexual orientation?
- Question 5 of 17
5. Question
If you selected Other for your sexual orientation please, specify otherwise enter NA:
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
- Question 6 of 17
6. Question
What is your racial identity?
- Question 7 of 17
7. Question
If you selected Other for your racial identity please, specify otherwise enter NA:
This response will be awarded full points automatically, but it can be reviewed and adjusted after submission.
- Question 8 of 17
8. Question
Are you Hispanic/Latino/Latinx?
- Question 9 of 17
9. Question
What is your date of birth? MM/DD/YYYY
/ /
- Question 10 of 17
10. Question
What is the highest level of education you have completed?
- Question 11 of 17
11. Question
What is your current marital status?
- Question 12 of 17
12. Question
Do you have any biological children, including any living outside the household?
- Question 13 of 17
13. Question
How many biological children do you have in the home that are between the ages of 12 to 20?
- Question 14 of 17
14. Question
Do you have any non-biological children, including any living outside the household?
- Question 15 of 17
15. Question
Are you related to any of the non-biological children in your home?
- Question 16 of 17
16. Question
How many non-biological children do you have in the home that are between the age of 12 to 20?
- Question 17 of 17
17. Question
Is there another supportive caregiver present in the home?