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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!

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* 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
Emergency Shelter
Assistance paying your 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
Legal services
Housing with affordable rent
Assistance finding a job
Education services (including General Educational Development (GED) services)
Job Training or Employment services

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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?

0 of 15 answered
 

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