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* 1. Please share your name, the name of your program, and your contact information.

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* 2. Do you identify as an Indigenous organization?

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* 3. My community is ...

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* 4. What is your program/communities current Housing First status?

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* 5. How well does or how well do you think Housing First will work in your community from 0 meaning it does not or will not work at all to 10 suggesting that it is or would be highly effective. 

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i We adjusted the number you entered based on the slider’s scale.

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* 6. Please provide your reasons for your response above.

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* 7. We are looking for programs that would be willing to participate in a Housing First Fidelity Self-Assessment process which would include completing an initial self-assessment checklist, then participating in some consultation, then completing another self-assessment using a revised Rural and Remote Housing First Fidelity Checklist. Would you be willing to participate?

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* 8. Please check any of the HF items below that do not or will not work in your community.

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* 9. What are the key barriers that make implementing a Housing First program in your community difficult? Check any that apply.

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* 10. Has your community done any kind of homeless count?

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* 11. Please provide details about answer above such as when a count occurred or is being planned, how many were counted, etc.

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* 12. What else if anything would you like to say about Housing First in your community?

0 of 12 answered
 

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