Survey for Parents and Families Question Title * 1. We appreciate your participation in our survey. For completing our survey, you will be entered into a drawing to win a $100 Visa gift card. Please enter your email address and daytime phone number to be contacted in the event you are the selected winner. email address day time phone Question Title * 2. Which age group are you in? Under 18 18-24 25-39 40-59 60+ Question Title * 3. With which race or ethnic group do you most strongly identify White or Caucasian Black or African American Hispanic or Latino Caribbean Haitian Asian or Asian American American Indian or Alaska Native Native Hawaiian or other Pacific Islander Another race Question Title * 4. Do you have children under age 18 in your household or that you care for on a regular basis? Or are you or immediate family expecting children in the coming months? Yes No Question Title * 5. What languages are spoken in your home? (Check all that apply.) English Spanish Creole/French Other (please specify) Next