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The Passaic County Department of Human Services is taking a fresh look at the needs, experiences, and interests of county residents, with the goal of improving county human services for everyone.  The focus of this survey is to assess the local strengths and needs of the residents of our county.  We value your feedback and hope you will share your thoughts with us by answering the questions below.  This information will be used to assess what services are needed, what improvements in services might be needed, and how the human service needs of Passaic County individuals and  families could be better met.

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* 1. Please tell us about a little about yourself.
I live in Passaic County?

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* 2. My zip code is:

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* 3. My age is:

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* 4. What is your race?

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* 5. What is your ethnicity?

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* 6. What is your gender?

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* 7. My marital status is:

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* 8. Are you a veteran?

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* 9. How many persons live in your household?

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* 10. Are there any individuals in your household under age 18?

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* 11. If yes, their ages are (please check all that apply):

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* 12. What is your employment status?

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* 13. Highest Level of Education ?

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* 14. Please describe your role in the community?

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* 15. Have you or someone in your household accessed services within the past 2 years?? (Such as case management, community center support, job training, food support, shelter/housing services, welfare, substance misuse treatment, mental health treatment, youth services, or others) 

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* 16. Have you or someone in your Household had DCF Division of Child Protection & Permanency (CP&P) involvement?

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