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Survey on Homelessness
1.
Your initials:
2.
Survey Number:
3.
Which two of the following reasons do you believe are the most common reasons for homelessness?
Poverty
Substance abuse / addiction
Mental illness
Lack of family / friend support
Veteran / PTSD
Other (please specify)
4.
How would you rate the city’s ability to care for our homeless population?
Excellent
Okay
Needs improvement
Poor
Other (please specify)
5.
Whose responsibility is it to help the homeless?
Federal government
State government
Local government
Charities
Other (please specify)
6.
How do you respond to someone who is begging for money?
I try to give them some money.
I try to give them food or water.
I ignore them.
Other (please specify)
7.
Have you ever volunteered to work in a homeless shelter?
Yes
No
8.
If you found yourself temporarily homeless, do you think that you have a family member or a friend who could house you and your family?
Yes
No
Not Sure
