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THE BLACK IMPROPER LLC
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Full Nmae
Email
Phone
Pronouns
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What are your gender pronouns?
Age
HOW OLD ARE YOU?
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Ethnicity
Black or African American
Asian
White
American Indian
Middle Eastern or North African
Hispanic Latinx or Spanish origin
Native Hawaiian or other pacific islander
What's your ethnicity background?
Gender
How do you identify?
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Current location
WHAT Area ARE YOU FROM?
Personal health information
Have you ever been prescribed PrEP ?
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Choose an option
Have you ever taken PrEP ?
Dorchester
Roxbury
Mattapan
Hyde Park
South Boston
South end
Charlestown
Roslindale
Chelsea
Revere
East Boston
Downtown Boston
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