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* 1. Which of the following best describes your current employment status?

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* 2. What Industry best describes the work you’ve done in the last 2 years?

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* 3. What is your yearly household income?

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* 4. Are there any individuals with military connections in your immediate family?

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* 5. Do you have a disability or chronic health condition?

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* 6. Have you or an immediate family member ever needed legal help (both free or paid legal assistance) in Florida?

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* 7. Do you know how to access the following (Select all that apply)?

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* 8. Please select all that apply to you or a family member in the past 2 years.

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* 9. What did you do for legal help (Select all that apply)?

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* 10. Please select all that apply to you or a family member in the past 2 years.

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* 11. What did you do for legal help (Select all that apply)?

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* 12. Have any of these been legal issues for you or a family member in the past 2 years?

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* 13. What did you do for legal help (Select all that apply)?

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* 14. Have you or a family member experienced any of these legal issues in the past 2 years?

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* 15. What did you do for legal help (Select all that apply)?

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* 16. How do you feel about your current job or employment situation?

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* 17. Have you or a family member experienced any of these issues in the past 2 years?

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* 18. Do you have student loans

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* 19. If yes, are the required payments affecting your economic stability?

The following questions ask you to consider problems or issues that you - or someone you live with - may have had in recent years. Please think about the year or so before COVID-19, as well as your situation since the pandemic and stay-at-home order in March 2020.

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* 20. Were you worried or concerned that you may not have stable housing?

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* 21. Did you have problems (eg. paying rent, getting things repaired, etc) with the place where you live?

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* 22. Was it often difficult getting to where you needed to go because of distance or transportation?

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* 23. Were you food insecure, meaning that you didn't have enough to eat?

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* 24. Were your utilities shut off or threatened to be shut off?

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* 25. Did you have problems getting child care that made it difficult for you to work or study?

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* 26. Do you often feel lonely or isolated?

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* 27. Because of cost, do you ever have to choose between necessities?

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* 28. Have you experienced discrimination or been treated unfairly because of your race or ethnicity?

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* 29. Have you faced challenges because you speak a language other than English?

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* 30. Did you or anyone in your immediate family struggle with mental illness?

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* 31. Did you or anyone in your immediate family experience drug or alcohol addiction?

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* 32. Have you or anyone in your immediate family had experience with the criminal justice system?

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* 33. Have you had issues getting or keeping a good job?

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* 34. Do you have serious health problems or are living with a disability?

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* 35. Over the last two years what issues or concerns do you find yourself worrying about most?

The following questions ask if you have experienced issues when interacting with the government or the courts. Please consider government agencies including Child & Family Services, Job Services, Social Security, the Bureau of Motor Vehicles, the VA, or Vital Records.

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* 36. Have you ever experienced any of these service issues when interacting with the government or the courts? (Check all that apply)

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* 37. Have you ever experienced any of these other issues when interacting with the government or the courts? (Check all that apply)

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* 38. Do you or anyone in your household currently or in the past 2 years use any of the following benefits? (Check all that apply):

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* 39. Were any of your applications denied or any of your benefits terminated?

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* 40. Do you have children age 18 or younger? (this is our only required question so that people without children won't have to answer all of the child-related questions. You can select Yes or No (either way) to move forward.

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