LGBTQIA+ Health Disparity Survey

Share Your Experiences Accessing Healthcare!

If you have ever experienced health disparities, please fill out this brief survey. Tennessee Justice Center wants to learn about your experiences to better educate people about these issues and get them to take action to fix the problems in our healthcare system.

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Contact Information

First Name Last Name

Pronouns

Gender Sexual Orientation

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(Optional)

Please complete the below form questions:

1. Do you currently have health insurance?

Yes

2. Have you ever felt discriminated against based on your sexual orientation or gender identity while you were getting health care?

Yes

If you selected yes for the question above, please tell us about your experience(s). (Optional)

3. Do you know anyone who has ever felt discriminated against based on their sexual orientation or gender identity while they were getting health care? (Optional)

Yes

4. Are you interested in advocating for LGBTQIA+ access to health care? (Optional)

Yes