Demographics



Please provide the following information.



What is your age?
 
 
Are you male or female?
  Male
  Female
 
Racial Self-Identificaton
  White-non hispanic
  African American
  Hispanic
  Native American
  Asian or Asian American
  Biracial or Multiracial
   Other (please specify):
 
What is your current relationship status?
  Single
  Married/In a relationship
  Divorced
  Would rather not say
 
What is your sexual orientation?
  Heterosexual
  Homosexual
  Bisexual
  Not sure, or would rather not say