Emergency Shelter Emergency Shelter Emergency Shelter Emergency Shelter Emergency Shelter Are you currently Bus Passes Bus Passes Bus Passes Bus Passes Bus Passes Transitional Housing Transitional Housing Transitional Housing Transitional Housing Transitional Housing accessing any of the Mental Health Mental Health Mental Health Mental Health Mental Health Alcohol/Drug Alcohol/Drug Alcohol/Drug Alcohol/Drug Alcohol/Drug following services in Counseling Counseling Counseling Counseling Counseling the community? Employment Employment Employment Employment Employment Drop-in/Day Shelter Drop-in/Day Shelter Drop-in/Day Shelter Drop-in/Day Shelter Drop-in/Day Shelter [Mark all that apply] Free Meals Free Free Free Meals Free Meals Legal Assistance Legal Assistance Assistance Legal Assistance Assistance Immigration Immigration Immigration Immigration Immigration Health Services Health Services Health Services Health Services Health Services Other: Other: Other: Other: Not Using Services Not Using Services Not Using Services Not Using Services Not Services ⃝ ⃝ ⃝ ⃝ ⃝ Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Head of Household Person 2 Person 3 Person 4 Person 5 Rental Subsidy Rental Subsidy Rental Subsidy Rental Subsidy Rental Subsidy What services Legal Assistance Legal Assistance Legal Assistance Legal Assistance Legal Assistance Deposit Money Deposit Money Deposit Money Deposit Money Deposit Money assist you in Utility Costs Utility Costs Utility Costs Utility Costs Utility Costs Employment Employment Employment Employment Employment securing stable services services services services services housing? Family Support Help Family Support Help Family Support Help Family Support Help Family Support Help Other: Other: Other: Other: Other: [Mark all that Know Doesn’t Know Know Doesn’t Know Doesn’t Know ⃝ ⃝ ⃝ ⃝ ⃝ Refused Refused Refused Refused Refused ⃝ ⃝ ⃝ ⃝ ⃝ Head of Household Person 2 Person 3 Person 4 Person 5 Of the following Shelter Restrictions Shelter Restrictions Shelter Restrictions Shelter Restrictions Shelter Restrictions ⃝ ⃝ ⃝ ⃝ ⃝ options, can you tell Have family/friends Have family/friends Have family/friends Have family/friends Have family/friends ⃝ ⃝ ⃝ ⃝ ⃝ me the number one or pet on the street or pet on the street or pet on the street or pet on the street or pet on the street reason that is Safety concerns Safety concerns Safety concerns Safety concerns Safety concerns ⃝ ⃝ ⃝ ⃝ ⃝ preventing you from staying in a shelter? Addiction to Addiction to Addiction to Addiction to Addiction to ⃝ ⃝ ⃝ ⃝ ⃝ Alcohol/Drugs Alcohol/Drugs Alcohol/Drugs Alcohol/Drugs Alcohol/Drugs
Are you currently accessing any of the following services in the community? [Mark all that apply] Emergency Shelter Bus Passes Transitional Housing Mental Health Alcohol/Drug Counseling Employment Drop-in/Day Shelter Free Meals Legal Assistance Immigration Health Services Other: ⃝ Not Using Services ⃝ Doesn’t Know ⃝ Refused Emergency Shelter Bus Passes Transitional Housing Mental Health Alcohol/Drug Counseling Employment Drop-in/Day Shelter Free Legal Assistance Immigration Health Services Other: ⃝ Not Using Services ⃝ Doesn’t Know ⃝ Refused Emergency Shelter Bus Passes Transitional Housing Mental Health Alcohol/Drug Counseling Employment Drop-in/Day Shelter Free Assistance Immigration Health Services ⃝ Not Using Services ⃝ Doesn’t Know ⃝ Refused Emergency Shelter Bus Passes Transitional Housing Mental Health Alcohol/Drug Counseling Employment Drop-in/Day Shelter Free Meals Legal Assistance Immigration Health Services Other: ⃝ Not Using Services ⃝ Doesn’t Know ⃝ Refused Emergency Shelter Bus Passes Transitional Housing Mental Health Alcohol/Drug Counseling Employment Drop-in/Day Shelter Free Meals Assistance Immigration Health Services Other: ⃝ Not Services ⃝ Doesn’t Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 What services assist you in securing stable housing? [Mark all that Rental Subsidy Legal Assistance Deposit Money Utility Costs Employment services Family Support Help Other: ⃝ Know ⃝ Refused Rental Subsidy Legal Assistance Deposit Money Utility Costs Employment services Family Support Help Other: ⃝ Doesn’t Know ⃝ Refused Rental Subsidy Legal Assistance Deposit Money Utility Costs Employment services Family Support Help Other: ⃝ Know ⃝ Refused Rental Subsidy Legal Assistance Deposit Money Utility Costs Employment services Family Support Help Other: ⃝ Doesn’t Know ⃝ Refused Rental Subsidy Legal Assistance Deposit Money Utility Costs Employment services Family Support Help Other: ⃝ Doesn’t Know ⃝ Refused Head of Household Person 2 Person 3 Person 4 Person 5 Of the following options, can you tell me the number one reason that is preventing you from staying in a shelter? ⃝ Shelter Restrictions ⃝ Have family/friends or pet on the street ⃝ Safety concerns ⃝ Addiction to Alcohol/Drugs ⃝ Shelter Restrictions ⃝ Have family/friends or pet on the street ⃝ Safety concerns ⃝ Addiction to Alcohol/Drugs ⃝ Shelter Restrictions ⃝ Have family/friends or pet on the street ⃝ Safety concerns ⃝ Addiction to Alcohol/Drugs ⃝ Shelter Restrictions ⃝ Have family/friends or pet on the street ⃝ Safety concerns ⃝ Addiction to Alcohol/Drugs ⃝ Shelter Restrictions ⃝ Have family/friends or pet on the street ⃝ Safety concerns ⃝ Addiction to Alcohol/Drugs
2018-Working-Survey-1.docx