consumer_mh
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you a consumer of mental health services?, type: esriFieldTypeString
, Coded Values:
[Yes (Currently): Yes (Currently)]
, [Yes (Previously): Yes (Previously)]
, [No: No]
, ...1 more...
)
consumer_ads
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you a consumer of alcohol and/or drug services?, type: esriFieldTypeString
, Coded Values:
[Yes (Currently): Yes (Currently)]
, [Yes (Previously): Yes (Previously)]
, [No: No]
, ...1 more...
)
friend_consumer
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you a friend, family member, or loved one of a consumer of mental health services and/or alcohol and drug services?, type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
, [Decline: Decline to State]
)
served_military
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Have you ever served in the military?, type: esriFieldTypeString
, Coded Values:
[Yes (Currently): Yes (Currently)]
, [Yes (Previously): Yes (Previously)]
, [No: No]
, ...1 more...
)
race
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Which category best describes your race?, type: esriFieldTypeString
, Coded Values:
[American Indian or Alaskan Native: American Indian or Alaskan Native]
, [Asian: Asian]
, [African American/Black: African American/Black]
, ...4 more...
)
ethnicity
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Which category best describes your ethnic/cultural background?, type: esriFieldTypeString
, Coded Values:
[Hispanic or Latino: Hispanic or Latino]
, [Non-Hispanic or Non-Latino: Non-Hispanic or Non-Latino]
, [Decline to State: Decline to State]
)
job_field
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you work in any of the following areas/fields? (check all that apply), type: esriFieldTypeString
)
sbcounty
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you live or work in San Bernardino County, if both list the region you live in:, type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No, I live and work in a neighboring California County]
)
sbcounty_region
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Please specify which region in San Bernardino County:, type: esriFieldTypeString
, Coded Values:
[CVR: Central Valley Region (e.g. Bloomington, Fontana, Grand Terrace, Rialto)]
, [DMR: Desert/Mountain Region (e.g. Adelanto, Amboy, Apple Valley, Baker, Barstow, Big Bear City, Cima, Earp, Fort Irwin, Hesperia, Hinkley, Joshua Tree, Landers, Ludlow, Morongo Valley, Mountain Pass, Needles, Nipton, Parker Dam, Phelan, Pioneertown, Sky Forest, Sugarloaf, 29 Palms, Wrightwood, Yermo, Yucca Valley)]
, [EV: East Valley (e.g. Green Valley Lake, Highland, Lake Arrowhead, Loma Linda, Lytle Creek, Mentone, Patton, Redlands, Rimforest, Running Springs, San Bernardino, Yucaipa)]
, ...1 more...
)
disability
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you have a disability or other impairment that substantially limits major life activity, which is not the result of a severe mental illness?, type: esriFieldTypeString
, Coded Values:
[Yes: Yes]
, [No: No]
, [Decline: Decline to State]
)
meeting_feedback
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Rate the meeting 1-5 (1 being poor and 5 being great), type: esriFieldTypeString
, Coded Values:
[5: 5]
, [4: 4]
, [3: 3]
, ...2 more...
)
feedback_entry
(
nullable: true, editable: true, defaultValue: null, length: 2000, alias: Any feedback on today's meeting?, type: esriFieldTypeString
)
future_updates
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: In the future how would you like to receive updates? (check all that apply), type: esriFieldTypeString
)
contact_info
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If you wish to provide your name and contact information for future updates, please do so below, type: esriFieldTypeString
)
thanks
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Thank you for taking the time to complete this survey. Your feedback will help us improve the community planning process to better meet the needs of our community. All information provided will be kept confidential., type: esriFieldTypeString
)