2023/2024 Priorities Survey - Client Please take a few minutes to answer some questions about legal problems you might have. This survey will help Legal Aid decide what kinds of cases to take. For some questions you may choose more than one answer. Thank you for your help. OK Question Title * 1. What Tennessee county do you live in? Anderson Bedford Campbell Cannon Cheatham Claiborne Clay Coffee Cumberland Davidson DeKalb Dickson Fentress Franklin Giles Grundy Hickman Houston Humphreys Jackson Lawrence Lewis Lincoln Macon Marshall Maury Montgomery Moore Morgan Overton Perry Pickett Putnam Roane Robertson Rutherford Scott Smith Stewart Sumner Trousdale Union Van Buren Warren Wayne White Williamson Wilson Other (please write below) OK Question Title * 2. Please check all that apply. My income is low. I came to the U.S. from another county. I have children under 18 in my home. I am disabled. I am a veteran. I have people over age 60 in my home. I need a job. I am age 60 or older I have someone in my home who does not speak English well. I have gotten help from Legal Aid. I am retired. Other (please write below) OK Question Title * 3. Please check one. I own my own home. I live in public or Section 8 housing. I live in a place where I pay the whole rent. I live with others and pay my own way. I live with others and do not pay rent and/or my own way. I am homeless. I pay rent OK Question Title * 4. During the past year has anyone in your household had legal problems with (OK to check more than one) Getting or paying for medicine? Getting mental health services? Medicare? Getting hospital services? Private health insurance? TennCare? Getting home health care? Paying medical bills? Getting a doctor's services? Getting nursing home care? Other health problem? (please write below) OK Question Title * 5. During the past year has anyone in your household had legal problems with (OK to check more than one) Getting a divorce or separation? Juvenile court? Family violence / spouse abuse / other abuse my someone you know? Child custody or visitation? Name change? Getting child support? Grandparents' rights? Divorce Guardianship of a child or conservatorship for an adult who can't make decisions for themself? Adoption? Other family problem? (please write below) OK Question Title * 6. During the past year has anyone in your household had legal problems with (OK to check more than one) Getting ripped off? Bankruptcy? Something wrong on your credit report? Unfair credit? Bill collectors? Check advance or title loan company? Collecting money owed to you? Bills you can't pay? Identity theft? Getting credit? Other money problem? (please write below) OK Question Title * 7. During the past year has anyone in your household had legal problems with (OK to check more than one) Being evicted or locked out without going to court? Making mortgage payments? Private landlord? Public or Section 8 housing? Unfair credit? Foreclosure? Having utilities cut off by landlord? Unsafe or unhealthy rental property? Other housing problem? (please write below) OK Question Title * 8. During the past year has anyone in your household had legal problems with (OK to check more than one) Unemployment benefits? Workers' Comp? Social Security Disability benefits (SSDI)? Wage claims Social Security Retirement benefits? Veterans' benefits? SNAP or Food Stamps? Supplemental Security Income (SSI)? Income tax Other public benefits problem? (please write below) OK Question Title * 9. During the past year has anyone in your household had legal problems with (OK to check more than one) Paying public school fees for supplies or field trips? Wills? School discipline? Cleaning up criminal record? Driver's or other license? Income taxes? Special education? Immigration? Court costs? Any other problem not listed? (please write below) OK DONE