Gender
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Female
Male
Age
1. What is your race/ethnicity?
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American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Some other race
Two or more races
2. Have you ever visited a country or culture different from your own?
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Yes
No
3. Have you ever lived in a country or culture different from your own?
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Yes
No
4. Have you ever taken a course on cultural diversity?
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Yes
No
5. Are you bilingual?
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Yes
No
6. Have you ever taken a language course other than your own?
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Yes
No
7. Have you studied or read extensively about a culture besides your own?
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Yes
No
8. Do you have friends who are of a culture besides your own?
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Yes
No
9. Have you ever attended an event of an ethnicity other than your own?
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Yes
No
10. Have you ever visited a doctor of a different ethnicity than your own?
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Yes
No
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