Gender (select one) Male Female Transgender Male Transgender Female Intersex Non-Binary Prefer not to answer

Age Range ** (select one) 0-12 13-17 18-24 25-34 35-44 45-54 55-64 65 or older Prefer not to answer

Ethnicity * Black or African American Asian American Indian or Alaska Native Native Hawaiian or Other Pacific Islander Hispanic or Latino Caucasian/White Multiracial Prefer not to answer