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* 1. What county do you live in?

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* 2. What is your zip code?

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* 3. Please respond to the following questions.

  Yes No Not sure
Have you ever heard of Legal Aid of Western Ohio (LAWO)?
Have you ever asked LAWO for help with a legal issue?
Have you ever heard of Advocates for Basic Legal Equality (ABLE)?
Have you ever asked ABLE for help with a legal issue?
Do you trust lawyers?

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* 4. In general, how would you rate the following parts of your life?

  Excellent Good Fair Poor
Housing
Physical Health
Mental Health
Financial Situation
Current Job or Employment Situation
Reliable Transportation
Family & Household Relationships
Neighborhood
Community
Citizenship Status 

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* 5. How often do these statements describe you?

  Always Sometimes Rarely Never
I have enough money to pay my bills.
I have enough people I feel comfortable asking for help at any time.
When I have a problem, I know where to turn or know how to figure it out.
I feel safe in my home, neighborhood, and community.
I have reliable internet so I can do what I need online.
I am able to set aside money for an emergency
I make contributions to a savings account or investments
I do not worry about money

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* 6. Think about the place you live. Do you have any problems with any of the following?

  Yes No Not sure
Bug infestation
Mold
Lead paint or lead pipes
Inadequate heat
Oven or stove not working
Water leaks
No or broken smoke detectors
Rodents
Clean drinking water
Disconnected utilities (gas, light, water)
Absentee landlord

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* 7. Have you experienced the following?

  Yes No
Have you ever had to miss a medical appointment due to lack of transportation?
Have you ever not been able to get the things you need because of lack of transportation?
Do you have difficulty affording transportation?
Do you live close to public transit?

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* 8. What are the issues in your community that need to be addressed?

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* 9. What has worked in your community to get problems solved?

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* 10. Would any of the following be helpful in getting community problems solved?

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* 11. What can non-profit lawyers do to help solve community wide problems?

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* 12. The following questions ask you to consider problems or issues that you - or someone you live with - may have had in recent years. Please think about the year or two before COVID-19 as well as your current situation.

  Yes, currently experiencing this problem Yes, experienced this recently but not anymore No, never experienced
Have you or anyone in your household experienced discrimination or been treated unfairly because of your race or ethnicity?
Have you or anyone in your household faced challenges because you speak a language other than English?
Do you or anyone in your immediate household struggle with mental illness?
Do you or anyone in your immediate household experience drug or alcohol addiction?
Have you or anyone in your household had experience with the criminal justice system?
Have you or anyone in your household had  issues getting or keeping a good job?
Do you or anyone in your household have serious health problems or are living with a disability?

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* 13. Have you ever experienced any of these issues when interacting with the government or the courts?

  Yes No Not sure
Information wasn't available in my language
I wasn't able to get an interpreter
Document instructions or procedures weren't clear 
There were too many referrals. I was passed from one person to another
No one answered the phone or I was on hold too long
Hours were not convenient
I couldn't get an appointment
No one would listen to my problem
The process moved too slowly or took too long
Services weren't available close to my home, work, or school
I had a bad past experience with lawyers
I experienced racial profiling by law enforcement
I need an accommodation for a disability and I did not get it
Getting someone to help me (like a lawyer) was too expensive
Fees charged by courts or governments were too high
I had transportation challenges
I could not find someone to watch my children
The courts of government are intimidating
I don't know the right questions to ask

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* 14. What is the best way to tell people about legal services available through Legal Aid or ABLE?

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