2019 PIT Youth Survey Question Title * 1. Where did you sleep last night? Outside Vehicle Abandoned or empty building Waiting room (hospital, bus station, etc.) Business (fast food place, store, etc.) Hotel/Motel Friend's couch/room Shelter Jail/Juvy With someone I do not feel safe with Other (please specify) Question Title * 2. What is your gender? Female Male Transgender Gender non conforming Don't know, refuse to answer Question Title * 3. What is your race? American Indian or Alaska Native Black or African American White Asian Native Hawaiian or other Pacific Islander Multiple races Don't know/Refuse to answer Question Title * 4. Are you Hispanic or Latino? Yes No Don't know/refuse to answer Question Title * 5. How old are you? 16-17 18-24 Question Title * 6. Which of the following best represents your identity? Lesbian or gay Straight Bisexual Something else I don't know I'd rather not say Question Title * 7. Have you ever served in any branch of the United States military? Yes, I have No, I have not Question Title * 8. Have you ever been placed in foster care? Yes No Question Title * 9. If you add up all the times you have been in a shelter, on the streets or sleeping in a place not meant to live in over the past three years about how much time does it add up to- your best guess is fine. Question Title * 10. Do you receive an SSI check? Yes No Question Title * 11. Have you ever received any of the following services? Special Education Mental Health Addiction Services Pregnancy Services Regular care for medical problems Question Title * 12. Have you ever been physically, emotionally or sexually abused by a relative or another person you have stayed with? Yes No Question Title * 13. Do you have HIV/AIDS? Yes No Don't know Question Title * 14. Are you currently enrolled in school? Yes and attend regularly Yes, suspended No, dropped out No, obtained GED or graduated high school/college Yes, but only go sometimes Don't know Question Title * 15. What's the reason you left or lost your last stable housing? Chose to leave-non specific Kicked out Don't know Refuse to answer Evicted Kicked out due to gender identity/sexual orientation Kicked out due to addiction Chose to leave because my parents/family is involved in drugs/crime/violence or another situation I wanted to get away from. Other (please specify) Question Title * 16. In order to stay in any housing situation, have you ever.... Stayed with someone you didn't know or trust Stayed somewhere that didn't feel safe Had sex to have somewhere to stay Stayed on a couch or floor longer than a week None of the above Refuse to answer Other (please specify) Question Title * 17. If you don't want to be contacted, please create a user name using first and last initial and year of birth so we make sure we don't count your survey twice. Question Title * 18. If you need help, you can call or text 779-208-0710 or leave your name and number below. Done