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Submit your feedback using the brief form below. Please complete and submit the survey only once. You may choose to complete the survey without providing your name and contact information. We do not share website visitor information with third parties.


1. What medical and mental health topics affecting the LGBT community are most important to you?


2. Which of the following topics interest you? Check all that apply.

Aging
Alternative health care
Anal health
Body image for women
Body image for men
Cancers in men
Cancers in women
Chronic illness
Disabled community/
 accessibility
Domestic violence
Depression/anxiety
Drugs/alcohol
Emotional health
Fertility and pregnancy
Fitness and nutrition
HIV/AIDS
Health care access
Health care differences for LGBTs
Hepatitis
Intersex health
Men's sexual health
Multiple chemical sensitivities
Parenting
STDs and safer sex for men
STDs and safer sex for women
Seniors
Transgender health
Violence and hate crimes
Women's health
Youth
Other


3. What site features are you likely to use? Check all that apply.

Condition information
Educational videos
E-mail newsletter about LGBT health
Health conferences and events specific to LGBTs
Links to LGBT health resources
Message boards for peer interaction about LGBT health and
 wellness
Online support groups
Forum for interacting with LGBT-friendly providers
Search for LGBT-friendly providers
Wellness and prevention education
Other


4. How would you rate the site in terms of usability? Choose one.

User-friendly
Mostly user-friendly but with a few confusing parts
Confusing
If you found any problems with usability, please describe as specifically as possible:


5. Other comments


Optional Fields (for demographic purposes)

Which of the following applies to you? Check all that apply.

LGBT health care consumer
Ally of an LGBT health care consumer
LGBT-friendly health care provider
Other

Gender

Age:
under 18
18-25
26-39
40-49
50-59
60-69
70+

Contact Information (Optional)

Name:
E-mail Address:
Phone Number:

Your personal information is kept private and confidential. Healthcommunities.com and lgbthealthchannel do not share visitor information with third parties. See our privacy policy.

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