Your Voice Matters!

Thank you for taking the time to answer these questions. Your feedback helps us create programs and events for the community and connect individuals and families to resources based on your needs and interests.

All fields marked with * are required and must be filled.

Thank you for taking the time to share your feedback. This brief survey focuses on your satisfaction with your living experience and your sense of safety in and around your home—your input helps us improve services and build a stronger community.

All fields marked with * are required and must be filled.

Property Name

Property Number

Name

First NameLast Name

Date of Birth

MonthDayYear

Email

example@example.com

Phone Number

Please provide a valid phone number.Format: 000-000-0000.

1. How do you prefer to be contacted?

2. What is the best time of day to reach you?

3. If your lease ended today, how likely would you be to renew?

4. On a scale of 0-10, would you recommend this property to someone in need of housing? (10 = most recommend)

A. Property Manager

B. Maintenance Staff

C. Security Staff

A. My neighbors at this property are welcoming and look out for one another

B. My input or feedback influences what happens at this property

C. I feel safe in my unit

D. I feel safe in common areas

7. Maintenance Request Timeliness

A. Building Cleanliness

B. Outdoor/Green Space

C. Laundry Room

D. Common Area Internet/Wi-Fi

E. Parking Lots

F. Pest Control

G. Quality of your Apartment Unit

H. Heating, Cooling, and Ventilation in your Apartment

3. How safe and functional is your home? (unit or apartment, not neighborhood)

4. How well can you manage utility expenses such as heat, electric, gas, oil, phone, and internet?

9. Are you registered to vote?

10. How satisfied are you with your social interactions? This includes family, friends, neighbors, religious or social organizations, and activities at the property.

11. Which of the following best describes your current employment status?

A. Rent

B. Utilities

C. Food

13. How familiar are you with managing your finances using tools like budgets, credit scores, online bill payments, and tax credits?

14. How well can you manage everyday expenses?

15. In the past year, did you ever run out of food and couldn't afford to buy more?

A. I am satisfied with the Resident Service Coordinator

B. I know the Resident Services Coordinator and know how to reach them

C. The event programming is relevant and useful (e.g. coffee hours, healthy living events; food programs)

16. What programming would you like to see more of on-site?

17. Do you have access to a personal computer or phone that can connect to the internet?

18. Is the internet in your unit reliable?

19. In the last year, have you taken steps to advance your education or job readiness by enrolling in a program such as a certificate program, GED, ESL classes, trade school, or vocational coursework?

20. Which best describes your current education goals or status? (This can include GEDs, certificates, job training, or college.)

21. Are you currently seeking employment opportunities?

21a. If no, which describes your situation?

21h. Have you seen a primary care physician in the last year?^

22. Do you have health insurance?

22a. If you have health insurance, what type of health insurance do you primarily use?

**Medicaid may be called the following depending on your state: Masshealth, Connecticut Medicaid (HUSKY), Rhode Island Medical Assistance, New York Medicaid, New Jersey Family Care, Pennsylvania Medical Assistance, Maryland Medicaid, DC Medicaid, Medi-Cal, Ohio Medicaid, Medical Assistance or MA (Michigan), Health Choice Illinois (HCI), Health First Colorado.

23. To live comfortably, there are many tasks to accomplish such as getting dressed, bathing, and walking. Some people receive assistance with these tasks in their homes. Which describes your situation?

A. Living at this property gives me access to healthcare services I would not otherwise have (i.e. on-site health screenings)

25. Are there children under age 18 living in your home? If "No", then SKIP to Demographic Information.

26. Do your children have health insurance?

27. Are your children involved in programs such as early education, afterschool, sports, summer camps, or employment?

28. Compared to a year ago, how are your children doing overall?

28. Would you like assistance with the following? Check all that apply.

29. Race

30. Ethnicity

31. Language

Please Specify

32. Are you a U.S. Veteran?

33. What is your highest level of education?

32. Which of the following benefits or assistance programs do you or someone in your household currently receive? (select all that apply)

33. What is one specific thing we could do to improve your living experience here?

Record ID (do not edit)

Selected Language

zzz. Resident Service Coordinator

zzz. Leasing Staff

zzz. Quality of the building

zzz. Exterior lighting in your apartments

zzz. Lobby

zzz. Acoustics (noise) in your apartment

zzz. Community room

zzz. Gym/fitness room

zzz. Common areas

zzz. Garden/planters

zzz. Walkways

zzz. Playgrounds

zzz. Your building’s parking/outdoor areas

zzz. The neighborhood

zzz. How confident are you in your ability to pay rent on time?

zzz. Please select which services you are interested in. (Check all that apply)

zzz. Which factors contribute to your dissatisfaction with social interactions? (Check all that apply)

zzz. Please select which services you are interested in. (Check all that apply)

zzz. How likely do you think it is that you will achieve your financial goals within your desired timeframe? Examples of financial goals are moving to a different apartment/home, starting a business, having enough money to retire, etc.

zzz. How accessible is transportation for you?

zzz. Please select which benefit services you are interested in. (Check all that apply)

zzz. Please select which services you are interested in. (Check all that apply)

zzz. Do you see a primary care physician every year?

zzz.Do you have health conditions that you manage?

zzz. Do you have access to affordable healthy food?

zzz. Where have you received medical care in the last year? (Check all that apply)

zzz. Please specify which hospital

zzz. What work experience do you have?

zzz. Please specify other

zzz. If you are managing health conditions, how confident are you in managing them?

zzz. Select all activities for which you are receiving assistance (Activities of Daily Living)

zzz. Name of person helping

First NameMiddle NameLast Name

zzz. Organization (if applicable)

zzz. Phone Number of person helping

Please enter a valid phone number.Format: (000) 000-0000.

zzz. Email of person helping

example@example.com

zzz. Select all activities for which you are receiving assistance (Activities of Independent Daily Living)

zzz. Please select which services you are interested in. (Check all that apply)

zzz. Please specify which health center

zzz. Have your children seen a primary care physician in the last year?

zzzz. If your children have health insurance, what type of health insurance do you primarily use?

zzz. Did your child(ren) advance to kindergarten or the next grade level this past year?

zzz. Please select which services you are interested in. (Check all that apply)

Your Voice Matters!

Your Contact Information

Community Satisfaction

5. Please rate your overall satisfaction with the building’s staff in the following areas:

6. Rate your agreement (5 = Strongly Agree, 4 = Agree, 3 = Neither Agree nor Disagree, 2 = Disagree, 1 = Strongly disagree, Not Applicable/Don't Know):

8. Please rate your overall satisfaction with the following areas:

Housing

Community Engagement

Community Building

Economic Mobility

Housing Stability and Economic Opportunity

12. Within the past 12 months, have you or anyone living in your household gone without or been unable to pay:

Resident Services (if applicable)

15. Rate agreement: 5 = Strongly Agree, 4 = Agree, 3 = Neither Agree nor Disagree, 2 = Disagree, 1 = Strongly Disagree, Not Applicable / Don't Know

Digital Connection

Education

Learning

Employment

Health

Health and Wellbeing

24. Rate your agreement (5 = Strongly Agree, 4 = Agree, 3 = Neither Agree nor Disagree, 2 = Disagree, 1 = Strongly disagree, Not Applicable/Don't Know):

Dependent Child(ren) (0-18yrs.)

Assistance Request

Optional Demographic Information

zzz. Please rate how safe you feel in the following areas (4 = Very Satisfied, 3 = Satisfied, 2 = Dissatisfied, 1 = Very Unsatisfied, 0 = Not Available/Don't Know):