LGBTQIA+ Campus Climate Survey Form
LGBTQIA+ Campus Climate Survey
How do you identify your gender?
Woman
Man
Nonbinary / Genderqueer
Prefer not to say
Other
How do you identify your sexual orientation?
Lesbian
Gay
Bisexual
Transgender
Queer
Asexual
Questioning
Prefer not to say
Other
How inclusive do you feel the campus environment is for LGBTQIA+ individuals?
*
Not at all inclusive
1
2
3
4
Extremely inclusive
5
1 is Not at all inclusive, 5 is Extremely inclusive
How safe do you feel on campus as an LGBTQIA+ individual?
*
Not at all safe
1
2
3
4
Completely safe
5
1 is Not at all safe, 5 is Completely safe
Have you experienced or witnessed discrimination or microaggressions related to LGBTQIA+ identity on campus in the past year?
*
Yes, experienced personally
Yes, witnessed
No
Prefer not to say
How comfortable do you feel accessing campus resources and support services as an LGBTQIA+ individual?
*
Not at all comfortable
1
2
3
4
Very comfortable
5
1 is Not at all comfortable, 5 is Very comfortable
Please rate your overall satisfaction with the campus climate for LGBTQIA+ individuals.
*
1
2
3
4
5
Which campus resources have you found most helpful for LGBTQIA+ students? (Select all that apply)
LGBTQIA+ student groups
Counseling services
Inclusive facilities (e.g., all-gender restrooms)
Faculty/staff support
Peer networks
None
Other
Please indicate your level of agreement with the following statements about campus climate for LGBTQIA+ individuals.
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
The campus fosters a sense of belonging for LGBTQIA+ individuals.
1
2
3
4
5
Faculty and staff are supportive of LGBTQIA+ students.
6
7
8
9
10
Campus policies support LGBTQIA+ inclusion.
11
12
13
14
15
LGBTQIA+ students are treated with respect by peers.
16
17
18
19
20
If you have any suggestions for improving the campus climate for LGBTQIA+ individuals, please share them below.
Submit
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