Client Survey

Please answer the following questions to help us understand your legal needs.

Question Title

* 1. Please look at the following list of problems and check if you or someone you know experienced that specific problem in the last 12 months.

1. Eviction or threat of eviction

2. Landlord shut off utilities (water or electric) or locked you out of your home.

3. Problems with getting title to a mobile home that you already paid for.

4. Foreclosure on home mortgage.

5. Problems with a landlord.

6. Difficulty finding affordable housing.

7. Housing discrimination (Denied housing because of race, religion, gender, national origin, or disability).

8. Tax problems (issues with the IRS or county property taxes).

9. Problem getting a home mortgage, small business loan or other loan

10. Denial of medical care by a doctor or hospital due to lack of insurance

11. Problems related to debt (garnishments, overdue bills, personal bankruptcy, and collectors calling frequently).

12. Exploitation or abuse of a senior citizen.

13. Issues faced by or in caring for a senior citizen.

14. Difficulties with your child’s school / education (disability, suspension, expulsion, access to alternative schooling, IEPs).

15. Problem regarding public benefits (food stamps, disability benefits through Social Security, Medicaid or Medicare).

16. Job discrimination (in hiring or on the job due to disability, race, religion, gender, national origin or sexual orientation/gender identify).

17. Problems with worker’s compensation or unemployment insurance

18. Barriers (such as lack of child care or transportation) to participating in work and training programs.

19. Child custody / visitation problems.

20. Divorce or family break up.

21. Domestic violence.

22. Problems related to making or receiving child support payments

23. Problems related to immigration or naturalization

24. Criminal record preventing employment

25. Victim of human trafficking (e.g. cannot safely quit a job, working to pay off a debt instead of pay, employer holding on to identification documents)

Other (please specify)

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* 2. If you answered checked off any of the above, please describe:

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* 3. Was legal help sought out for these problems?

Yes

If not, why?

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* 4. Please select the top 5 legal problems that you think low income individuals and families face.

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* 5. Have there been other times during the past year that you thought you might need a lawyer, but didn’t get help from one?

Yes

If so, describe?

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* 6. What has prevented you or someone you know from seeking out legal assistance for the problem?

Didn’t know there was a legal issue or possible solution

Wasn’t sure who to call

Couldn’t find anyone I could afford

I spoke to a lawyer but he or she refused to help

I couldn’t get to the lawyer’s office

Language or cultural problems

Fear

Other

If "Fear" or "Other" was chosen, please explain what you mean by those answers.

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* 7. What specific suggestions or ideas do you have to make it easier to access legal help?

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* 8. What County do you live in?

Charlotte

DeSoto

Glades

Hardee

Hendry

Highlands

Lee

Martin

Okeechobee

Palm Beach

Polk

St. Lucie

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* 9. What is your race?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

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* 10. What is your Gender?

Male

Female

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* 11. What is your age?

18-40

41-59

60+

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* 12. What is your annual household income?

Less than $12,000

$12,000-$25,000

$25,001-$39,999

$40,000 +