General Assistance Survey

The purpose of this survey is to gather information and stories from Pennsylvanians who have lost their General Assistance. The information on this form will be kept confidential and used only by Community Legal Services unless you indicate that we may share this information by marking YES in the first box. This survey can be completed by people who are losing their General Assistance or family, friends, or social service providers who are helping people who are losing their General Assistance.
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