Wyoming Homeless Consumer Survey

We are wanting consumer perspective on gaps in homeless services and disparities in access for persons of racial and/or ethnic minorities. Thank you for your willingness to complete this survey!

Question Title

* 1. In the past year, which of the following services did you need?

	Received help	Needed, but did not get help	Did not need help
Necessities such as food, clothing, hygiene supplies	Necessities such as food, clothing, hygiene supplies Received help	Necessities such as food, clothing, hygiene supplies Needed, but did not get help	Necessities such as food, clothing, hygiene supplies Did not need help
Emergency Shelter	Emergency Shelter Received help	Emergency Shelter Needed, but did not get help	Emergency Shelter Did not need help
Assistance paying your rent	Assistance paying your rent Received help	Assistance paying your rent Needed, but did not get help	Assistance paying your rent Did not need help
Assistance with transportation	Assistance with transportation Received help	Assistance with transportation Needed, but did not get help	Assistance with transportation Did not need help
Help locating a place to live	Help locating a place to live Received help	Help locating a place to live Needed, but did not get help	Help locating a place to live Did not need help
Healthcare	Healthcare Received help	Healthcare Needed, but did not get help	Healthcare Did not need help
Mental health services	Mental health services Received help	Mental health services Needed, but did not get help	Mental health services Did not need help
Substance abuse services	Substance abuse services Received help	Substance abuse services Needed, but did not get help	Substance abuse services Did not need help
Services for Veterans	Services for Veterans Received help	Services for Veterans Needed, but did not get help	Services for Veterans Did not need help
Services for victims of domestic violence	Services for victims of domestic violence Received help	Services for victims of domestic violence Needed, but did not get help	Services for victims of domestic violence Did not need help
Help finding or paying for childcare	Help finding or paying for childcare Received help	Help finding or paying for childcare Needed, but did not get help	Help finding or paying for childcare Did not need help
Legal services	Legal services Received help	Legal services Needed, but did not get help	Legal services Did not need help
Housing with affordable rent	Housing with affordable rent Received help	Housing with affordable rent Needed, but did not get help	Housing with affordable rent Did not need help
Assistance finding a job	Assistance finding a job Received help	Assistance finding a job Needed, but did not get help	Assistance finding a job Did not need help
Education services (including General Educational Development (GED) services)	Education services (including General Educational Development (GED) services) Received help	Education services (including General Educational Development (GED) services) Needed, but did not get help	Education services (including General Educational Development (GED) services) Did not need help
Job Training or Employment services	Job Training or Employment services Received help	Job Training or Employment services Needed, but did not get help	Job Training or Employment services Did not need help

Question Title

* 2. Which services are most needed, but hardest to find near you? You can select up to five services

All services are available in my area

Necessities such as food, clothing, hygiene supplies

Emergency Shelter

Assistance paying rent

Assistance with transportation

Help locating a place to live

Healthcare

Mental health services

Substance abuse services

Services for Veterans

Services for victims of domestic violence

Help finding or paying for childcare

Housing with affordable rent

Assistance finding a job

Legal services

Education services (including General Educational Development (GED) services)

Job training or employment services

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* 3. Have you ever felt you were denied services because of your race?

Yes

I don't know

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* 4. What is your age?

Under 18

18-24

25-50

51-64

65+

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* 5. How many people are in your household including yourself?

1 (Single)

5 or more

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* 6. Are there children under the age of 6 in your household?

Yes

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* 7. Are there children ages 7-17 in your household?

Yes

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* 8. What is your race? (Check all that apply)

White/Caucasian

Black/African American

Asian

Native American/Alaskan Native

Native Hawaiian/Pacific Islander

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* 9. Are you Hispanic?

Yes

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* 10. Which County do you live in?

Teton

Natrona

Washakie

Sublette

Sweetwater

Niobrara

Platte

Laramie

Uinta

Fremont

Lincoln

Goshen

Campbell

Big Horn

Hot Springs

Carbon

Albany

Weston

Converse

Johnson

Sheridan

I don't know

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* 11. Have you been homeless in the past year?

Yes

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* 12. How many times have you been homeless in the past year?

4 or more

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* 13. Have you been continually homeless for a year or more in the past 3 years?

Yes

Wyoming Homeless Consumer Survey

Question Title

* 1. In the past year, which of the following services did you need?

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* 2. Which services are most needed, but hardest to find near you? You can select up to five services

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* 3. Have you ever felt you were denied services because of your race?

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* 4. What is your age?

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* 5. How many people are in your household including yourself?

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* 6. Are there children under the age of 6 in your household?

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* 7. Are there children ages 7-17 in your household?

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* 8. What is your race? (Check all that apply)

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* 9. Are you Hispanic?

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* 10. Which County do you live in?

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* 11. Have you been homeless in the past year?

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* 12. How many times have you been homeless in the past year?

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* 13. Have you been continually homeless for a year or more in the past 3 years?

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* 14. Do you have any comments regarding services for persons who are homeless or who need help to keep them from becoming homeless?

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* 15. Are there any services you or someone in your family needs that are not listed above?