sex_birth
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What sex were you assigned at birth?, type: esriFieldTypeString
, Coded Values:
[Female_2: Female]
, [Male_2: Male]
, [Prefer_not_2: Prefer not to answer]
)
gender_describe
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: How do you describe yourself?, type: esriFieldTypeString
, Coded Values:
[Female_3: Female]
, [Trans_Female: Trans Female/Woman]
, [Genderqueer: Genderqueer]
, ...6 more...
)
language_group
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: What is the primary language spoken in your home?, type: esriFieldTypeString
)
consumer_mhs
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you a consumer of mental health services?, type: esriFieldTypeString
)
consumer_substances
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you a consumer of alcohol and/or drug services?, type: esriFieldTypeString
)
family_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_8: Yes]
, [NO_8: No]
, [Prefer_not_8: Prefer not to answer]
)
field_work
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you connected to any of the following stakeholder groups (Employed, Affiliated, Represent, Lived Experience)?, type: esriFieldTypeString
)
disability
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you have a disability or other impairment that is expected to last longer than 6 months and substantially limits a major life activity, which is not the result of a severe mental illness?, type: esriFieldTypeString
, Coded Values:
[YES_13: Yes]
, [NO_13: No]
, [Prefer_not_13: Prefer not to answer]
)
zipcode
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you live or work in San Bernardino County? If both, enter the ZIP code OR City you live in:, type: esriFieldTypeString
)
live_work
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you live in one of the following cities: San Bernardino, Fontana, Ontario, Rancho Cucamonga, or Victorville?, type: esriFieldTypeString
, Coded Values:
[YES: Yes]
, [NO: No]
, [Prefer_not: Prefer not to answer]
)
neighbor
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: I live and work in a neighboring California County., type: esriFieldTypeString
, Coded Values:
[prefer: Prefer not to answer]
)
mhsa
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: In the future how would you like to receive MHSA updates?, type: esriFieldTypeString
)
housing
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: After learning about the Housing Intervention under BHSA and our current Homeless Services, do you have any suggestions for improvement?, type: esriFieldTypeString
)
supportive
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: How can DBH Homeless and Supportive Services best engage your community?, type: esriFieldTypeString
)
satisfied
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Were you satisfied that this meeting met its goals and/or objectives?, type: esriFieldTypeString
, Coded Values:
[Very_Satisfied: Very Satisfied]
, [Satisfied: Satisfied]
, [Neutral: Neutral]
, ...2 more...
)
feedback
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: Any additional comments or feedback?, type: esriFieldTypeString
)
project
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: Do you support this project moving forward? Why or why not?, type: esriFieldTypeString
)
free_app
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: Do you think a free app that teens can contact for help with mental health, food, housing, or other support would be helpful for teens in your community?, type: esriFieldTypeString
)
recommend
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: If the app were available, how likely would you be to use it or recommend it to a friend or family member who needed help?, type: esriFieldTypeString
)
confidential
(
nullable: true, editable: true, defaultValue: null, length: 1000, alias: Would having a private confidential, teen-friendly app make it easier for you to ask for help when you need it?, type: esriFieldTypeString
)