Housing Location Services Survey

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* 1. Name

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* 2. Organization’s Name

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* 3. Organization's Address

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* 4. Organization's City

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* 5. Organization's State

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* 6. Organization's Zip code

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* 7. Your Email

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* 8. Your Phone

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* 9. Type of Organization (check all that apply)

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* 10. Check All Housing Location Services your agency offers to prospective renters:  (Agencies may provide some or all of the following services. Please check all services your agency offers.)

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* 11. What populations are eligible for the housing location services you identified above?  Individuals who are/have:

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* 12. Which of following factors does your agency consider when determining eligibility to receive  housing location services:

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* 13. How does your agency provide housing location services?

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* 14. In which jurisdictions does your agency offer housing location services? (check all that apply)

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* 15. Do the housing location services offered by your agency differ by locality?

If your agency is currently providing any form of housing location services please complete questions 16-18.

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* 16.  How many people are you able to provide housing location services to concurrently?

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* 17. In addition to the client base listed in the previous question, how many new people could you serve with housing location services given your current staffing?

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* 18. How is your agency currently compensated for providing housing location services? (Check all that apply)

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