*1.What community do you work in?(Required.)

Town/City

*2.Type of organization you work at:
Check multiple if applicable(Required.)

Childcare

Job Training

Education

Elder Services

Housing

Financial Assistance

Food Assistance

Healthcare

Behavioral Health

Addiction/Recovery Services

Domestic Violence Services

Legal Assistance

Other (please specify)

*3.What do you think are the top issues impacting people in your community? (Check top three)(Required.)

Lack of affordable housing

High utility and heating costs

Low availability of living-wage jobs

High cost or lack of childcare options

Inadequate public transportation

Limited access to mental health care

Substance use and addiction concerns

High cost or lack of access to health care

Food insecurity

Social isolation

Domestic violence and lack of safe supports

Lack of access to reliable technology and internet

Difficulty accessing legal assistance

Barriers faced by immigrants and non-English speakers

4.Based on your experience, what barriers limit access to services in our community? (Check top three)

Lack of awareness of available services

Transportation challenges

Scheduling conflicts (work or childcare)

Services not available in preferred language

Technology or digital access barriers

Limited availability of services in the area

Stigma associated with seeking help

Fear related to immigration status

Unsafe or unstable home environment

Other (please specify)

5.Based on your experience, what are the gaps in services that most impact individuals and families in our community?

6.Are there areas where you'd like to see more community partnerships or collaboration? For example: shared outreach, combined case management, co-hosted events, joint grant opportunities, etc.

7.Do you have any other concerns about the community and how we as community organizations are serving them?

8.Name (Optional)