Thank you for helping the court improve its services by briefly answering the following questions:

* 1. Please choose your primary language from the list below.

* 2. Please choose your age from the selection below:

* 3. When did you visit the free self-help center or clinic?

I visited on:
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/
:

* 4. Which self-help location did you visit?

* 5. Was this your first time visiting a self-help desk?

* 6. How did you find out about the Self-Help Center?

* 7. Up to now, which resources have you used to find the bankruptcy information and assistance you have needed?

* 8. Did you speak to a Court staff person in the Clerk's Office?

* 9. Did you meet with an attorney during your visit?

* 10. Did the Self-Help Center staff or attorney refer you to outside resources or agencies that could help you?

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