Community Needs & Resources Survey

This survey is to assess the need for resources/services in your community. Help us by sharing what services you need and ones your already use. Visit our site GetConnectedNewHaven.com for more information on New Haven resources that can serve you and your family once you complete this survey.

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* 1. Today's Date

Date:

Date

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* 2. What is your age?

Under 18

18 to 24

25 to 34

35 to 44

45 to 54

55 to 64

65 to 74

75 or older

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* 3. Gender

Male

Female

Other

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* 4. What neighborhood do you live in?

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* 5. Do you know about our website Get Connected New Haven?

Yes

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* 6. If yes, how often do you visit the site?

Often

Once in a while

Barely ever

I don't visit this site

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* 7. Do you have access/ability to use the internet?

Yes

If no, please explain

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* 8. If yes, where do you access it?

At home

At the library

At an agency/ organization

Someone does it for me

Other (please specify)

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* 9. Is someone helping you with your search?

Yes

Case worker

Friend

Agency

Faith community representative

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* 10. Do you need help finding services?

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* 11. If yes, please select which one(s) below.

Basic Needs

Employment

Food Assistance

Addiction and Recovery

Housing

Healthcare

Early Childhood (childcare, schooling, etc.)

Financial Support

Here you can more than one service.

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* 12. Do you know other people who would benefit from knowing about this site?

Yes

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* 13. If so, what would be the best way to let them know about this service?

Word of mouth

Care workers

Post card mailed to their address

Business cards

Grocery Stores

Hospitals

Other agencies

Here you can specify more than one option.

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* 14. Do you know where services are in your neighborhood?

If yes, please specify.

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* 1. Today's Date

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* 2. What is your age?

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* 3. Gender

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* 4. What neighborhood do you live in?

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* 5. Do you know about our website Get Connected New Haven?

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* 6. If yes, how often do you visit the site?

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* 7. Do you have access/ability to use the internet?

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* 8. If yes, where do you access it?

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* 9. Is someone helping you with your search?

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* 10. Do you need help finding services?

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* 11. If yes, please select which one(s) below.

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* 12. Do you know other people who would benefit from knowing about this site?

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* 13. If so, what would be the best way to let them know about this service?

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* 14. Do you know where services are in your neighborhood?

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* 15. Please share with us any questions, comments, or concerns you have.