Please help us improve this website by answering the following questions. Completing this questionnaire will take approximately 5 minutes or less.
1. How did we do? Please list the tools or pages you liked best
a.
b.
c.
d.
2. Please rate the following aspects of the site for each section of the site you used (scale excellent, good, average, poor, very poor, not used). If you indicate less than average, please indicate the specific page or section to which you are referring.
navigation
organization
content clarity
content accuracy
comprehensiveness
Competence
Overview
Assessment
Multicultural
Competencies
Social Justice
Advocacy
Resources
Activities
1. Socioracially (Check all are significant identifications for you)
American Indian or Alaska Native
Arab or Middle Eastern
Asian
African American or Black
Caribbean
Latino
Native Hawaiian or other Pacific Islander
South Asian
White
Other
2. National status:
Foreign born and immigrated within past 5 years
Foreign born and immigrated 5-10 years ago
Foreign born and immigrated more than 10 years ago
Born in the U.S.
3. Language fluency:
English only
English and one other language
English and two other languages
English and three or more other languages
4. Disability status:
Physical disability acquired within past 10 years
Sensory disability acquired within past 10 years
Other type of disability acquired within the past 10 years
Physical disability acquired more than 10 years ago
Sensory disability acquired more than 10 years ago
Other type of disability acquired more than 10 years ago
Born with physical disability
Born with sensory disability
Born with other type of disability
No disability
5. Sexual orientation:
gay or lesbian
bisexual
heterosexual
other
6. Gender identity:
Female
Male
Transgender
7. Age:
8. Religious or Spiritual affiliation:
Buddhism
Catholic
Christian
Judaism
Muslim
Shintoism
No religious or spiritual affiliation
Other
9. Primary Occupation:
Professor
Practicing Counselor, Social Worker or Psychologist
Administrator
Researcher
Student
10. Work setting:
University or 4 year College
College (2 year)
Hospital
Community Agency
School (K-12)
Government
Private Practice:
Other:
11. What is the community like in which you work?
rural
suburban
urban
12. What is the ethnic diversity of the community in which you work?
American Indian or Alaska Native
Arab or Middle Eastern
Asian
African American or Black
Caribbean
Latino
Native Hawaiian or other Pacific Islander
South Asian
White
Other
13. What would you estimate is the annual income of the families in the community in which you work?
Less than $10,000
$10,000 to $14,999
$15,000 to $24,999
$25,000 to $34,999
$35,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 to $199,999
$200,000 or more
14. Highest degree held in counseling, social work or psychology:
Ph.D.
M.S.W.
M.A. or M.S.
B.A., B.S. or B.S.W.
15. How long ago did you complete your highest degree?
1-5 years ago
5-10 years ago
10-15 years ago
15-25 years ago
25 + years ago
16. Extent of formal multicultural training you have completed:
No multicultural classes or workshops
Less than one multicultural course
One multicultural course (quarter or semester long)
One multicultural course + infused in other courses or workshops
More than one multicultural course
More than one multicultural course + infused in other courses and workshops
17. Overall, how extensively do you believe you integrate multicultural issues and/or approaches into your work?
Not at all
A little
Moderate
Extensively
All the time
18. Overall, how would you rate your multicultural expertise:
Very low<
Low
Moderate
High
Very high
19. Please rate the multicultural issues you feel most comfortable with:
Ethnicity and race
Gender
Sexual Orientation
Disabilities
Age
Religion
20. Please rate the multicultural issues you feel least comfortable with:
Ethnicity and race
Gender
Sexual Orientation
Disabilities
Age
Religion
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