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Homeless Experience Survey
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
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How is homelessness affecting you?
1
How long have you been experiencing homelessness?
Select the option that best represents the duration of your homelessness.
Less than 1 year
1-3 years
3-5 years
More than 5 years
2
Rate the support you receive from local community services.
Rate your experience from 1 to 10, 1 being very poor and 10 being excellent.
3
Share your biggest challenge while being homeless.
Describe the main obstacle you face during your homelessness.
4
Are you provided with adequate shelter options in your area?
Select yes or no if you have access to suitable shelter.
Yes
No
5
Rate the safety of the places where you usually spend your nights.
Rate the safety level from 1 to 10, 1 being very unsafe and 10 being very safe.
6
Do you have access to clean water and hygienic facilities?
Select yes or no if you have access to sanitary resources.
Yes
No
7
How would you rate the overall treatment you receive from society?
Rate your overall treatment from 1 to 10, 1 being very negative and 10 being very positive.
8
Have you faced discrimination or stigma due to your homelessness?
Select yes or no if you have experienced discrimination.
Yes
No
9
What type of support do you feel is lacking the most?
Share the kind of support you believe is most needed but missing.
10
How likely are you to recommend local resources for homeless individuals?
Rate your likelihood from 1 to 10, 1 being very unlikely and 10 being very likely.
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