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
)
mhs
(
nullable: true, editable: true, defaultValue: null, length: 255, alias: Are you a consumer of mental health services?, type: esriFieldTypeString
)
sudrs
(
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
)
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]
)
live_work
(
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]
, [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 do you live in or work?, type: esriFieldTypeString
, Coded Values:
[central: Central Valley Region (e.g., Bloomington, Fontana, 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, San Bernardino, 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
)