UVic Student Wellness Gender Affirming Care Survey Question Title * 1. Are you 18 years old or over? Yes No Question Title * 2. Are you a registered UVic student? Yes No Question Title * 3. Anticipate graduation year and term Question Title * 4. Have you ever received gender affirming care? Yes No Question Title * 5. If you have received gender affirming care before, where did you receive it and what for? Question Title * 6. Are you looking to access medical care for hormone initiation? Yes No Question Title * 7. Are you looking to restart hormones? Yes No Question Title * 8. Are you currently on hormones and looking for a renewal of your hormones without any concerns or request for adjustment? Yes No Question Title * 9. Are you on hormones and looking for a dose adjustment of your hormones? Yes No Question Title * 10. Are you looking for a surgery referral? Yes No Maybe/ Unsure Question Title * 11. If looking for surgery referral, what type of surgery are you interested in? Question Title * 12. Do you have BC MSP or another provincial health insurance? B.C. MSP Other provincial health insurance No provincial health insurance Question Title * 13. Please provide your full name as it appears on your ONECard. Question Title * 14. If applicable, please provide your preferred name. Question Title * 15. Please provide your preferred pronouns, if you'd like. Question Title * 16. What is your V-Number? Question Title * 17. Please provide your email address and a phone number to reach you. Email Address Phone Number Please provide your preferred method of communication (Email or Phone) Done