Parity, Inclusion, and Reflectiveness Survey (PIR) (2024)

Introduction

Welcome to the Parity, Inclusion, and Reflectiveness survey! As a commissioner, your participation is vital in shaping an inclusive and reflective environment within our Commission. This survey is a mandatory requirement, designed to be completed at least once, and sometimes twice a year. The information you provide is crucial for ensuring that our Commission meets HRSA's reflectiveness requirements.

Please note that any updates or changes to your information should be promptly communicated to our Commission staff, as this may impact your membership status. Your cooperation in this regard is greatly appreciated.

This survey should take approximately 5 minutes to complete. Should you require any assistance or have any questions, please don't hesitate to reach out to our Commission staff at hivcomm@lachiv.org or by calling 213.738.2816. We're here to help!

*Questions requiring responses are preceded by an asterisk.

Question Title

* 1. Contact Information

Name and Pronoun (For example: "John Smith, he/him/his") *

Do you work for an agency/organization? If yes, please state agency/org name and if not, please indicate "N/A" for not applicable. *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Primary Email Address *

Primary Phone Number *