This survey is anonymous. No name, email, or personal identity required.

Do not answer any questions that you do not feel comfortable answering.

This survey to assess Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ) homeless youth needs to create access in Kalamazoo county to services.

We believe your self identity, which may be other than LGBTQ, is important.  The first question provides space so that we can include your identity in the data.

Homeless Youth for this survey is defined as youth ages 13-24 who do not  physical live with a parent or guardian or may be “at risk” of not living with a parent or guardian in the future. This includes youth who have run away from home, been kicked out of their homes, been abandoned by parents, does not have a physical residence, or is “couch-surfing”.

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* 1. I identify as?

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* 2. The race/ethnic background I identify with is.


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* 3. How old are you?

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* 4. Please answer the remaining questions and assume that we would like to include your self identity/identities listed above as included in the “LGBTQ” questions listed below. Thank you.

Are you or do you know anyone who is not “coming out” to family for fear of becoming homeless?

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* 5. Are you or do you know anyone who identifies as LGBTQ and has ever experienced homelessness or has lived “couchsurfing”?

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* 6. If yes to question five, when was/is this?

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* 7. How long were/are you or your friend been without a permanent home?

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* 8. Have you ever been denied renting due to being LGBTQ?

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* 9. Are you aware of any resources in Kalamazoo County that you feel are safe for homeless LGBTQ youth to use? (i.e. shelter, food bank, clothing bank, etc..)

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* 10. If yes to question 9, Which ones?

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* 11. Have you or a friend who is experiencing homelessness ever used services?

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* 12. If yes to question 11, Which ones?

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* 13. Have you or a friend hidden or changed your identity to gain access to needed services?

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* 14. Have you or a friend ever been denied services for being LGBTQ?

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* 15. Have you or a friend who has experienced homelessness not used services like homeless shelter, food pantry, etc… for fear of being rejected for being LGBTQ?

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* 16. In what ways have you or would you or a friend use to locate LGBTQ homelessness resources?

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* 17. Have you or a friend that has experienced homelessness ever talked about what types of problems were the most important?

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* 18. If yes to question 18, what were they?

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* 20. Are you the person who had experienced homelessness?

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* 21. Please share any comments.

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