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NYC Demographic Survey

This survey is optional. Your answers are anonymous and confidential.

The results will help New York City agencies improve their services to residents. The survey will only be used for that purpose. Your answers will not affect your application or case in any way. You can skip questions you do not feel comfortable answering.

Your decision not to answer will not affect your application, case, or any other record in any way.

All written answers must be in English letters.  

Do you want to participate in this survey? *This question is required.
This question requires a valid number format.
What NYC agency did you apply for services with today? *This question is required.
What service did you apply for? *This question is required.
What service did you apply for? *This question is required.
What service did you apply for? *This question is required.
What service did you apply for? *This question is required.
What service did you apply for? *This question is required.
(Select one)
2. What races or ethnicities do you identify with? (Select all that apply)
3. What ancestries or heritages do you identify with?(Select all that apply)
4. Has anyone in your household served (or is currently serving) in the U.S. Armed Forces, National Guard or Reserves?(Select all that apply)
5. What is the language you speak most at home?(Select one)
6. What other languages do you speak?(Select all that apply)
7. How well do you speak English?(Select one)

8. How would you describe your gender?

(Select all that apply)

9. What sex were you given at birth?

(Select one)
10. Are you intersex?(Select one)
10a. If you are intersex, please select from below.(Select all that apply)
11. What is your sexual orientation?(Select all that apply)
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