Pre-Home Visit Questionnaire

Thank you so much for taking the time out of your day to complete this pre-home visit questionnaire. Your counselor will use your responses to guide the conversation at your home visit. The goal of the survey is to gain an understanding of how you are doing in your new home, what your experience has been in your new community, and what your current needs are so that we can assist you in settling in and thriving in your new community.

Emergency Contact

Housing Needs

Transportation Needs

Amenities and Services

For the following locations, indicate whether you have found the service or amenity in your new neighborhood

Housing Search