Date of Birth: MM slash DD slash YYYY Zip Code Gender Race/Ethnicity Type of Response:(Required)Pre-TestPost-TestHave you received a COVID-19 Vaccine?(Required) How many doses did you receive?(Required) Have you heard of the term Post Traumatic Slave Syndrome?(Required)YesNoUnsureHave you heard of the term Prenatal Trauma Exposure?(Required)YesNoUnsureHave you heard of the terms:(Required) Domestic or Intimate Partner Violence Educational Abuse Emotional Abuse/Neglect Financial Abuse/Neglect Medical Abuse Nutritional Neglect Sexual Abuse/Neglect Social Isolation Prefer not to say Other Select AllHave you or someone close to you been exposed to:(Required) Domestic or Intimate Partner Violence Educational Abuse Emotional Abuse/Neglect Financial Abuse/Neglect Medical Abuse Sexual Abuse/Neglect Social Isolation Prefer not to say Other Select All