Priority Setting Survey (Community Members)
You can help us make our services better. We want to know what issues community members are seeing so that we can better address those needs.
If you have any questions, please call (585)295-5656
Employment Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Loss of or difficulty finding a job
Problems finding or paying for childcare
Lack of affordable transportsation
Denial of unemployment benefits
Employment Discrimination
Problems getting paid (including for overtime)
Problems with a pension
Problems starting a small business
Problems with a job training program
Housing Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Homeslessness
Bad housing conditions (other than lead paint)
Lead paint problems
Problems with code enforcement response to complaints
Problem with law enforcement's response to landlord-tenant complaints
No access to public or subsidized housing
Discrimination in renting or home purchases
Eviction
Fell behind in rent
Need for special housing for persons with disabilities
Mobile home problems
Foreclosure of home/farm
Land contract problems
Landlord in foreclosure
Education Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Problems with reading and writing skills
Problems with getting GED
Problems with school suspension/discipline
Student loan problems
Problems getting access to job training programs
School violence
Need for special education
Problems getting access to school (e.g. residency issues, need for language services)
Family Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Intimate Partner Violence (domestic violence)
Sexual assault
Accusations of child abuse or neglect
Need for child custody or visitation
Lack of child support
Need to lower child support
Need for spousal support
Need to establish paternity
Child in foster care
Child in need of special placement
Divorce
Adoption
Name Change
Guardianship
Healthcare Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Serious physical illness or disability
Mental health problems
Problems getting medical care
Lack/loss of health insurance
Lack/loss of prescription drug coverage
Problems getting durable medical equipment
Problems getting drug and/or alcohol abuse treatment
Problems getting dental care
Problems with nursing home
Problems with medicaid
Problems with medicare
Problems with Child Health Plus
Government Benefits Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Denial/loss/reduction of public assistance
Denial/loss/reduction of social security disability or SSI benefits
Denial/loss/reduction of food stamps
Denial of emergency services (e.g. for food, housing or medicine)
Denial/loss/reduction of veterans benefits
Denial/loss/reduction of child care subsidy
Consumer Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Repossession of car
Filed for bankruptcy
Problems with creditors
Inability to obtain loans or credit at reasonable interest rates
Unpaid utility bills (electricity, gas, phone, water)
Rent to Own
Home improvement loan debt
Garnishment of wages
Other Issues: Check "Yes" if the following has happened to you or a household member in the past 2 years. *
Yes
No
Loss of driver's license
Victim of crime
Needed someone to help care for them in home or institution
Earned income tax credit
Other tax problems
Will
Power of attorney/other advance directives
Immigration status problem
Neighborhood safety
Elder abuse (physical, emotional, financial)
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