Union County Community Needs Assessment Questionnaire – Internal

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.
I use this service.
I know how to access this service.
Comments:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Health and Well Being

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Learning and Education

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Safety and Financial Security

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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