2018 Nevada Legal Needs - FEEDBACK FORM for Community Stakeholder Meetings

Question Title

* 1. Date of Meeting

Date / Time

Date

Question Title

* 2. Location of Meeting

Question Title

* 3. Survey Question 1. What is the city closest to you and/or your organization?

Las Vegas

Carson City

Reno

Elko

Ely

Pahrump

Tonopah

Yerrington

Winnemucca

Other (please specify)

Question Title

* 4. Survey Question. 2. Your ZIP Code:

Question Title

* 5. Survey Question 3. What best describes your field of work?

Legal (attorney, judge, paralegal, court staff, etc.)

Health care

Education

Government agency

Non-profit human services

Law enforcement

Business or banking

Other (please specify)

Question Title

* 6. Survey Question 4. Have you ever heard of any of these organizations before today? – please check all that apply:

Legal Aid Center of Southern Nevada

Nevada Legal Services

Southern Nevada Senior Law Program

Volunteer Attorneys for Rural Nevadans

Washoe Legal Services

Question Title

* 7. Survey Question 5. Who are your most significant constituents, related to the work of legal aid organizations in Nevada?

Your organization’s clients
or customers

Your organization’s
employees

Other

Question Title

* 8. Survey Question 5a. Add description for the answers that were checked for question 5.

Your organization’s clients
or customers – Describe >>

Your organization’s
employees – Describe >>

Other – Please list >>

Question Title

* 9. Survey Question 6. How often do you or your organization refer people to any of the above legal aid organizations?

Never

Less than once per month

1-2 times per month

3-5 times per month

6-10 times per month

11-20 times per month

More than 20 times per month

Question Title

* 10. Survey Question 7. What are the ONE or TWO most important UNMET civil legal needs or problems you see among the members of your constituency?

a. Please list:

b. Why are these important? Please summarize in a few bullet points – e.g., “1. [first bullet]; 2. [second bullet]....”:

c. What changes could legal aid providers make to help?

Question Title

* 11. Survey Question 8. Considering the following major areas covered by the findings of our legal needs study, please indicate how SIGNIFICANT they are to your organization or constituency. (Rate EACH of the following on a scale of 1 to 10, where 10 = VERY significant and 1 = NOT AT ALL significant ):

	1
a. Overview of legal aid: Who the legal aid providers are and what they do	a. Overview of legal aid: Who the legal aid providers are and what they do 1 menu
b. Whom we serve: the demographics of the low-income population in Nevada	b. Whom we serve: the demographics of the low-income population in Nevada 1 menu
c. Legal needs: The incidence and types of legal situations experienced by low-income Nevadans each year	c. Legal needs: The incidence and types of legal situations experienced by low-income Nevadans each year 1 menu
d. Economic impact: How legal aid saves costs and generates revenue benefiting low-income Nevadans and local economies	d. Economic impact: How legal aid saves costs and generates revenue benefiting low-income Nevadans and local economies 1 menu
e. The “Justice Gap”: The disparity between legal needs and the capacity of legal aid organizations to address them	e. The “Justice Gap”: The disparity between legal needs and the capacity of legal aid organizations to address them 1 menu
f. Solutions – Actions that can be taken for narrowing the Justice Gap	f. Solutions – Actions that can be taken for narrowing the Justice Gap 1 menu

OPTIONAL: What makes the above findings important to you or your constituency – please describe in a few bullet points – e.g., “1. [first bullet]; 2. [second bullet]....”:

Question Title

* 12. Survey Question 9. Do you see specific ways in which your organization could work with a legal aid provider to improve services to your low income community?

Yes

Question Title

* 13. Survey Question 9.a. If "yes" to survey question 9, then please check all that apply:

Coordinate services

Refer clients / customers to each other

Seek funding for a collaborative partnership – please indicate below the general issue or area the partnership would address:

Other - Please describe:

Question Title

* 14. Survey Question 10. Would you be willing to participate in a 15-minute phone conversation to discuss these topics further?

Yes

Question Title

* 15. Survey Question 10.a. If you answered "yes" to survey question 10, then please provider your contact information below:

Name

Email Address

Phone Number