LGBTQIA+ Resource Guide Survey

Please enter your zip code.

I am completing this survey as

A member of the LGBTQ+ community

An ally

If you have ever experienced homelessness (or slept in a car, stayed overnight in an emergency shelter, or stayed with a friend) due to eviction, lack of family support, lack of employment/income, or for any other reason, did you feel safe seeking services?

Yes

Does Not Apply

Are you aware of any service providers specifically dedicated for LGBTQ+ community members? Please list them.

Are you aware of any services that provide supplemental basic needs (i.e. food, clothing, life skills, etc.) for the LGBTQ+ community? Please list them.

If you are aware that such services exist, what barriers, if any, made services difficult to access? Could you describe the barriers?

If you have ever sought services or programming for your LGBTQ+ child, did you feel safe in seeking services?

Yes

Does Not Apply

Are you aware of any local programs that provide services for bullying or violence against LGBTQ+ youth? Please list those services.

Are you aware of any local programs that provide support to LGBTQ+ youth and families? Please list those services.

Are you aware of any safe and accepting childcare providers for LGBTQ+ youth or parents? Please list them.

If you are aware that such child and youth related services exist, what barriers, if any, made services difficult to access? Could you describe those barriers?

If you have ever sought services for a medical emergency, procedure, or diagnosis, did you feel safe seeking services?

Yes

Does Not Apply

If you have ever sought services for a medical emergency, procedure, or diagnosis, have you ever been denied medical care or treated differently based on your LGBTQ+ status? Could you describe those barriers?

Are you aware of any medical practitioners that provide services specifically to the LGBTQ+ community? Please the share the names of the service providers.

If you are aware that such medical services exist, what barriers, if any, made services difficult to access? Could you describe those barriers?

17. If you have ever accessed mental health services for any reason, did you feel safe seeking services?

Yes

Does Not Apply

Are you aware of any mental health services available for members of the LGBTQ+ community? Please list those services.

Are you aware of any mental health clinicians that provide services specifically to the LGBTQ+ community? Please list those clinicians.

If you are aware that such mental health services exist, what barriers, if any, made these services difficult to access?

Are you aware of any openly accessible support groups (teens, young adults, or seniors) for members of the LGBTQ+ community? Please list those support groups.

If you have ever been a victim of a crime (such as sexual assault, domestic violence, or a hate crime) did you feel safe calling the police?

Yes

Does Not Apply

Are you aware of any domestic violence or sexual assault services for the LGBTQ+ community? Please those services.

Are you aware of any resources to help with divorce, custody situations or other legal needs for the LGBTQ+ community? Please list those resources.

Please list LGBTQ+ friendly places such as shops, salons, restaurants, churches, etc. Where do you feel comfortable and accepted?

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