Wellness Research Survey

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* 1. What is your first and last name?

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* 2. What is your gender?

Female

Male

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* 3. What is your age?

18-24

25-34

35-44

45-54

55-64

65+

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* 4. If you could ask me 2 questions, what would they be?

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* 5. What is your occupation?