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]
)
military
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Have you ever served in the military?, type: esriFieldTypeString
)
race
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Which category best describes your race (i.e., physical/ancestral characteristics)?, type: esriFieldTypeString
)
field_work
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you connected to any of the following stakeholder groups (Employed, Affiliated, Represent)?, 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]
)
represent
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Do you live or work specifically in one of these five cities? San Bernardino (East Valley), Fontana (Central Valley), Ontario (West Valley), Rancho Cucamonga (West Valley), or Victorville (Desert/Mountain Region), type: esriFieldTypeString
, Coded Values:
[YES: Yes]
, [NO: No]
, [Prefer_not: Prefer not to answer]
)
yes_represent
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If yes, in which of the five cities do you live in or work?, type: esriFieldTypeString
, Coded Values:
[SanBernardino: San Bernardino]
, [Fontana: Fontana]
, [Ontario: Ontario]
, ...2 more...
)
live_work
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If no, do you live or work in any region of San Bernardino County?, type: esriFieldTypeString
, Coded Values:
[YES: Yes]
, [NO: No]
, [Prefer_not: Prefer not to answer]
)
yes_live_work
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: If yes, in which San Bernardino County region do you live in or work?, type: esriFieldTypeString
, Coded Values:
[Central: Central Valley Region (e.g., Bloomington, Grand Terrace, Rialto)]
, [Desert_mt: Desert/Mountain Region (e.g., Adelanto, Amboy, Apple Valley, Baker, Big Bear City, Cima, Earp, Fort Irwin, Hesperia, Hinkley, Joshua Tree, Landers, Lucerne Valley, Ludlow, Morongo Valley, Mountain Pass, Needles, Nipton, Parker Dam, Phelan, Pioneertown, Sky Forest, Sugarloaf, 29 Palms, Wrightwood, Yermo, Yucca Valley)]
, [East: East Valley (e.g., Green Valley Lake, Highland, Lake Arrowhead, Loma Linda, Lytle Creek, Mentone, Patton, Redlands, Rimforest, Running Springs, Yucaipa)]
, ...1 more...
)
zip_code
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: I live and work in a neighboring California County (Please list Zip Code):, type: esriFieldTypeString
)
mhsa
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: In the future how would you like to receive MHSA updates?, type: esriFieldTypeString
)