Please take a few minutes to fill out the customer needs assessment survey.  The results of this survey will help us to determine the 2021 Community Services Block Grant's programs.

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* 1. What county do you  live in?

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* 2. What is your zip code?

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* 3. What is your gender?

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* 4. Are you over age 55?

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* 5. Are you married or living with a partner?

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* 6. Which employment needs could you use help with?  (select all that apply)

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* 7. Which education needs could you or a family member use help with?  select all that apply.

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* 8. Which financial and/or legal needs could you or your family use help with?  (select all that apply.)

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* 9. Which housing needs could you or your family use help with?  (select all that apply)

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* 10. Which food and nutrition needs could you or your family use help with?  (select all that apply)

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* 11. Do you have children under the age of 18 living with you?  (if no skip to question 14)

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* 12. Which child development needs could you or your family use help with?  (select all that apply)

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* 13. If you have children under age of 18 living with you, which parenting and/or family support needs could you or your family use help with?  (select all that apply)

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* 14. Which transportation needs could you or your family use help with? ( select all that apply.)

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* 15. Which health needs could you or your family members use help with? (select all that apply)

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* 16. Which basic needs could you or your family use help with?  (select all that apply.)

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* 17. Are there any problems or needs that you or your family faced within the last 12 months that you were unable to get help with?  Please list.

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* 18. What is the ONE thing you would like to see improved in your neighborhood?

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* 19. How did you learn about Tazwood Community Services, Inc. and their services?

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* 20. What are your sources of household income?  select all that apply.

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* 21. In the past 12 months, how has your household's income changed?

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* 22. What time of the day would you prefer to come to one of our locations (office or intake site) for assistance?  Select one

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* 23. What services has your household received from our agency within the past 12 months?  (select all that apply)

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* 24. If you know anyone with an incarcerated adult in their family, do they ever talk about particular concerns that could be addressed through...  (select all that apply.)

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* 25. When you think about your adult family, friends and neighbors how many of them might say something like "there is no money left at the end of month" or "where am I going to find money to pay for that?  select one.

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* 26. When you think about your family, friends and neighbors, how many of them may have difficulties finding or buying enough quality food to provide at least three meals a day?  select one

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* 27. When you have time to rest or when you are ready to sleep, what kind of issues in your family or neighborhood keep you up?

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* 28. If given the opportunity, would you be willing to serve on a local board or committee that represents and makes decisions for families with low-income?

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* 29. Did Tazwood Community Services help you in a timely manner?

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* 30. The staff at Tazwood Community Services, Inc. treated me/us with respect?

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* 31. The staff at Tazwood Community Services, Inc. were helpful and friendly?

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* 32. I got the information and/or services that I needed from Tazwood Community Services, Inc.?

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* 33. I was informed of other agencies or community services by Tazwood Community Services, Inc.

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* 34. I  would recommend Tazwood Community Services, Inc. to family & friends.

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* 35. What is the one thing you would change about the services (in any)  received from Tazwood Community Services, Inc.

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* 36. Other comments or concerns?

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