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Transitional Housing (Scattered Site) Participation Survey
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Transitional Housing (Scattered Site) Participation Survey
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Transitional Housing (Scattered Site) Participation Survey
I feel that I have fully utilized the services offered through the Transitional Housing program.
Strongly Agree
Agree
Don't Know
Disagree
Strongly Disagree
I feel that I have actively pursued my established goals and have been successful in achieving them.
Strongly Agree
Agree
Don't Know
Disagree
Strongly Disagree
Staff was helpful in my housing search.
Strongly Agree
Agree
Don't Know
Disagree
Strongly Disagree
Rate the level of individual contact received by your Transitional Housing Case Manager.
Excellent
Good
Fair
Poor
How would you rate services provided by your Transitional Housing Case Manager?
Excellent
Good
Fair
Poor
How would you rate the availability of your Transitional Housing Case Manager?
Excellent
Good
Fair
Poor
What do you like best about the Transitional Housing Program?
What would you change or like to see improved about your housing?
Would you recommend the Transitional Housing Program to others? Why or why not?
Which of the following do you need, but currently cannot access (check all that apply):
Housing assistance (search, rental assistance, etc.)
Help with basic living skills
Food assistance (food pantry referrals, etc.)
Employment assistance (job search, resume building, interview skills, etc.)
Transportation assistance (bus tokens, transportation for those with physical disability)
Place to worship
Mental health services
Drug and alcohol counseling and treatment
Affordable medical care
Other (please describe below):
If you checked "Other" above, please describe:
Demographic Information
The following questions are optional and will help us know who is using our services so we can continue to improve our programs to meet the needs of all clients.
What ethnicity do you identify as?
What is your gender identity?
Female
Male
Transgender Male to Female
Transgender Female to Male
Gender Fluid
Non-binary
An identity not listed (please specify below)
Prefer not to disclose
If you checked "An identity not listed" above, please describe:
Your age:
How many children do you have?
What is your sexual orientation?
Heterosexual/Straight
Lesbian
Queer
Bisexual
Gay
Questioning
Asexual
Pansexual
Same-gender loving
An identity not listed (please specify below)
Prefer not to disclose
If you checked "An identity not listed" above, please describe:
How long have you been a resident?
Additional Comments or Concerns:
