Assessment Questionnaire

We believe that social service providers are critical agents in stabling vulnerable populations. Your participation in this questionnaire will serve as an opportunity to elevate the need and narrative of direct service agencies in relation to sustainability during COVID-19 and beyond, as well as assist us in reimagining what our Prevention Network can be.

There are a total of 13 questions. The first 7 questions are related to needs and services. The last 6 questions are related to collaboration.

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* 1. Agency and Provider Information 

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* 2. What is the primary function of your agency?

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* 3. What population do you primarily serve?

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* 4. Please select the top THREE needed for your agency to sustain during COVID-19

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* 5. What were the needs of your agency prior to COVID-19?

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* 6. Prior to COVID-19, how many people were served each month?

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* 7. Can you describe the gaps in service provision? (What barriers exists)

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* 8. What is the maximum capacity of people served

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* 9. What are the current goals of your agency?

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* 10. How does your agency work to achieve its goals? What methods are used?

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* 11. Which sectors are in alignment with the sector of work that your agency engages in?

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* 12. Describe the view that your agency has on collaborations and
partnerships with other agencies, Community-Based Organizations, and other networks/alliances.

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* 13. How interested would your agency be in organizing as a method and/or strategy to secure funding?

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* 14. What do you think are the top FIVE social determinants of health?

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* 15. Is there anything else that you would like to add?

0 of 15 answered
 

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