}
June 2, 2021

Eviction Prevention Followup Survey June 2021

Please answer the following questions as truthfully as possible, as we will be using your responses to expand our program over the coming year, and reporting back to our funders and elected officials as to where the greatest needs are in our communities.

Your name, and any other identifying information will never be shared with anyone outside our office, and all data is reported in the aggregate.

Eviction Prevention Followup Questions
Were you behind on your rent because of COVID? (After April 1, 2020) *
Did you apply for COVID-related county/city rental assistance? *
Were you approved for assistance? *
If you received rental assistance as a result of your application, did it pay for the total amount owed? *
Do you still owe rent now, as of June 2021? *
Since you contacted us, have you been evicted or received a court summons to appear in rent court for failure to pay rent? *
If you were evicted, where are you living now?
Race *
Your Gender *
Do you have a disability? *
Are there any additional resources you need right now?
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