Union County Community Needs Assessment Questionnaire

About the Questionnaire

Union County is interested in better understanding the needs of the individuals and families in the County, and is requesting your input. We value the feedback of our residents, and are hoping that you will share your thoughts with us by answering the brief set of questions, below. This information will help us work to assess what services are needed, what improvements in services might be needed, and how the human service needs of Union County residents could be better met.

The survey will take 20 - 30 minutes to complete, and is completely voluntary. There are no risks to you for participating in the survey, and no penalty for not participating. All responses will be anonymous and confidential, and your name is not required. Thank you for your time!

To easily navigate the survey, we suggest you use the TAB button on your keyboard to move field to field. The form is mobile, tablet and computer friendly.

Translate the Questionnaire

This feature using Google Translate is provided to assist County of Union residents. The County of Union makes no promises, assurances, guarantees or other representations as to the accuracy of these translations, and it will not be liable for any inaccuracies or errors in the translations. It expressly disclaims liability for any loss, damage or other problem resulting from any inaccuracies or errors including, without limitation, indirect or consequential damages of any kind.

Please tell us about a little about yourself

I live in Union County

My zip code is

My city

I am a provider of human services

My age is

My marital status is

How many persons live in your household?

Are there any individuals in your household under age 18?

What are their ages (Please check all that apply)

Family Relationships and Community Connections

Art/Music Events
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Coaching/Support Groups
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Support for Dealing with Community-based Bias
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Legal services/Legal Assistance
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Mentoring (examples - Big Brother/Big Sister, Peer Mentoring)
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Affordable Child Care
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Home Delivered Meals
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Food - Food Pantry, WIC, Farmers Market Vouchers
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Sports Events
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Parenting Classes, Skills and Supports
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Family Outings /Community Festivals, Events
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Internet/Virtual Community/ Social Media Groups
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Connections to Faith- based/Religious Facilities and Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Quality Infant/Toddler Early Education Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Volunteer Opportunities
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Anger Management Classes/Groups
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Health and Well Being

Health Insurance / Affordable Medical Care
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Transportation to Medical and Social Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Eye / Vision Care, including Eyeglasses
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Dental Care / Coverage
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Suicide Prevention
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Homecare Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Prevention Education (promoting healthy lifestyles)
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Supports for Persons with Special Needs
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Caregiver Support/Respite
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Developmental Health Services / Support Counseling
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Domestic Violence / Trauma Support
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Recovery Support Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Medicare/Medicaid Doctors / Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Hospice Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Accessing Doctors
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Preparation for Working with People with Special Needs
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Treatment for Mental Health Issues
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Substance Use Disorder Treatment Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Hospice Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Learning and Education

GED Classes/High School Diploma
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

English as Second Language Classes
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Computer Skills Training
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Trade School
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Finding a Better Paying Job
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Job Training for a Better Job
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Workforce Readiness Skills Development
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Youth Employment Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Job Skills Training
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Homework Help/Tutoring Child
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Transportation to Work or Training
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Special Education Services at Child’s School
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Career Counseling
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Services to Support Child’s Attendance at School
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Supplies for School for Child
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Money for Tuition (College, Trade, Vocational School)
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Supports to Help Teen Parents Stay In/Return to School
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Adult Basic Education/Literacy
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Safety and Financial Security

Finding Affordable Housing
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Utility / Home Energy Assistance
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Weatherization Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Mortgage Assistance
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Rent Assistance
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Foreclosure Assistance
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Saving for a Home/Home Ownership Help
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Services to Make Neighborhood Safer (Neighborhood Watch, etc.)
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Reverse Mortgage
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Home Repair
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Accessibility for Persons with Disabilities
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Help with Budgeting/Credit Counseling
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Filing Taxes
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Earned Income Tax Credit
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Support/Intervention to Prevent Homelessness
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Services to Prevent Abuse and Neglect
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Victim Assistance
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Gang Violence Prevention
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Probation / Community Service Hours
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Cooking Healthy Meals
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Fatherhood Classes
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Teen Pregnancy Support
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Neighborhood Clean Up Projects
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Crime Reduction
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

TANF/General Assistance (Welfare)
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Public Parks
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Post-Traumatic Stress Disorder Counseling
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Veterans Services
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Personal Safety Classes
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Sexual Assault Treatment
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Financial Assistance for Caregiving
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Elder Abuse Investigation
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Child Abuse Investigation
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

SNAP (Food Stamps)
I need this service. YesNo
I use this service. YesNo
I know how to access this service. YesNo
Comments:

Other Services

Are there any other services that you need that were not mentioned, above?

Please describe the other services you need

Please tell us more about yourself

Where do you live?

Do you live in Subsidized Housing/Public Housing or Section 8 Housing?

Are you living with others because you cannot afford to live on your own?

What is the annual income for your entire household?

What sources do you get your income?

How far did you get in school/what was your last grade completed?

What is your race?

What is your ethnicity?

What language, other than English, is spoken in your home?

What is your gender?

Please self-describe your gender

How do you see yourself?

If your sex assigned at birth does not align with your gender identity, you may identify as transgender. Other identities considered to fall under this umbrella can include non-binary, gender fluid, and genderqueer – as well as many more. Do you identify as transgender?

What is your Military Status?

Are you a primary caregiver for one or more grandchildren/relatives?

What are the ages of your grandchildren/relatives?

Are you a primary caregiver for another relative?

What is the relationship for your other relative?

Are you a primary caregiver for one or more non-relatives?

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