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Exit Survey »
 
 
How long have you been a participant in the Permanent Support Housing Program?
 
Less than 6 months
 
6 months to less than 1 year
 
1 year to less than 3 years
 
3 years to less than 5 years
 
5 years or more
 
 
What was your prior living situation before entering the program?
Emergency Shelter
Transitional Housing
With Friends or Family
In own rental housing
on the street
 
 
 
How would you rate your overall level of satisfaction with this program?
 
Highly satisfied
 
Somewhat satisfied
 
Neutral
 
Somewhat dissatisfied
 
Highly dissatisfied
 
Please rate the following needs of homeless and/or formerly homeless individuals or families in your community. This is an assessment of unmet/met needs based on all local resources.
met need unmet need
Assistance with personal hygiene
Food
Clothing
Immediate shelter (an emergency place to stay)
Transitional iving facility or halfway house
Long-term, permanent housing
Detoxification from substances
Treatment for substance abuse
Services for emotional or psychiatric problems
Treament for dual diagnosis
met need unmet need
Family counseling
Medical Services
Women's health care
Help with medication
Drop-in center or day program
AIDS/HIV testing/counseling
TB testing and treatment
 
Hepatitis C testing
Dental Care
met need unmet need
Eye Care
Glasses
VA disability/pension
Welfare payments
SSI/SSD process
Guardianship (financial)
Help managing money
Job training
Help with finding a job or getting employment
Help getting needed documents or identification
met need unmet need
Help with transportation
Education
Child care
Family reconciliation assistance
Spiritual
Re-entry services for incarcerated homeless individuals
Elder health care
Credit Counseling
Legal assistance for child support issues
Legal assistance for oustanding warrants/fines
Help developing a social network
 
 
 
Are you having difficulty paying utility bills?
 
Yes
 
No
 
 
 
Do you apply for the Low Income Home Energy Assistance Program (LIHEAP) for assistance with heating expenses?
 
Yes
 
No
 
 
 
What best describes your employment status?
 
Employed full-time
 
Employed part-time
 
Self-employed
 
Unemployed, looking for work
 
Unemployed, not looking for work
 
Student
 
Retired
 
Homemaker
 
Military
 
Prefer not to answer
 
Other
 
 
 
 
Has your income increased at all since entering the program?
 
Yes
 
No
 
 
 
Have you applied and/or are you on the waiting list for the Section 8 or public housing programs?
 
Yes
 
No
 
 
 
Do you have any suggestions for improvement?
   
 
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