Tea 2 Go - Harm Reduction Dispensing Survey

Demographic Information

Question Title

* 1. Gender:

Male

Female

Non-Binary / Gender Queer

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* 2. I identify as:

Gay

Bisexual

MSM (men who have sex with men)

Pansexual

Straight

Queer

Asexual

Other (please specify)

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* 3. Do you identify as a Trans individual?

Yes

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* 4. Please select your age category:

18 or under

19-25

26-35

36-45

46-55

56+

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* 5. Ethnicity (select all that apply):

Indigenous to Canada

African, Black, and/or Caribbean

East and/or Southeast Asian

Hispanic

Middle eastern, Arab, North African

South Asian

Caucasian

Other (please specify)

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* 6. Do you identify as a two-spirit individual?

Yes

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* 7. I am:

HIV positive (living with HIV)

HIV negative (living without HIV)

Unsure of my HIV status

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* 8. Residency status:

Canadian Citizen

Permanent Resident

Convention Refugee

Refugee Claimant

International student

Temporary worker / Work Permit Holders

Visitor

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* 9. Accessing the Online/In-Person Harm Reduction Dispensing Program has been beneficial.

Strongly agree

Agree

Neutral

Disagree

Strongly disagree

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* 10. I accessed harm reduction materials by:

Ordering Online for Delivery

Ordering Online for Pick-up

In-person pick-up

Ordering Online for Mail