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Introduction (type: esriFieldTypeString, alias: Introduction: Hi, my name is _______ and I'm a volunteer for the (NAME OF YOUR LHC or COC). We are here to talk to you about your housing and service needs and would like to ask for your consent to be interviewed. We will use this information to help us better serve individuals experiencing homelessness.This process should take about 10 minutes.The questions are about your health and housing.By participating in the interview, you grant permission for us to provide your information to authorized agencies to further services and housing in this community.Some of the questions we ask might make you feel uncomfortable or be upsetting. If you feel uncomfortable or upset during the interview, you may ask the interviewer to take a break or to skip any of the questions.You can also ask for clarification on any question.We are only interested in accurate information and there are no "correct" or "preferred" answers.The information that you give us during the interview will be stored in a secure network., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
CountyName (type: esriFieldTypeString, alias: County in which survey is being collected:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Beaver: Beaver], [BoxElder: Box Elder], [Cache: Cache], ... 26 more ...)
Survey (type: esriFieldTypeString, alias: Are you able to survey this person?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [yes: Yes], [no: No])
ContinueSurveyAgain (type: esriFieldTypeString, alias: Continue with the rest of the survey., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
NumberofPeople (type: esriFieldTypeString, alias: How many people do you see?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Sleep (type: esriFieldTypeString, alias: Where did you sleep on the night of Wednesday, January 24th?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Habitation: Place not meant for habitation (e.g., a vehicle, an abandoned building, bus/train/subway station/airport or anywhere outside)], [OtherLocation: Any other location])
Name (type: esriFieldTypeString, alias: Is this their full name or street name?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [FullName: Full name], [StreetName: Street name], [Refused: Individual Doesn't Know / Individual Prefers Not to Answer])
ClientBirthDate (type: esriFieldTypeString, alias: Birth Date Type, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [FullDate: Full DOB], [Approximate: Approximate or Partial DOB], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
ProvideBirthDate (type: esriFieldTypeString, alias: If client does not want to provide DOB, are you, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [UnderEighteen: Under 18], [EighteenTwentyFour: 18-24], [TwentyFiveThirtyFour: 25-34], ... 5 more ...)
Gender (type: esriFieldTypeString, alias: What is your gender identity?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Race (type: esriFieldTypeString, alias: What race or races do you identify with? Mark all that apply., SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
ActiveDuty (type: esriFieldTypeString, alias: Have you served on active duty in the United States Armed Forces (Army, Navy, Air Force, Marine Corps, or Coast Guard)?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
ApproximateDate (type: esriFieldTypeDate, alias: For this occasion of homelessness, about what date did you start sleeping in an emergency shelter or on the streets?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
NumberOfTimes (type: esriFieldTypeInteger, alias: Including this instance, how many separate times have you been homeless in the past 3 years, that is since January 2021? Only include time spent staying in shelters and/or on the streets., SQL Type: sqlTypeOther, nullable: true, editable: true)
HomelessMonths (type: esriFieldTypeInteger, alias: How many months total have you been homeless in the past 3 years, that is since January 2021? Only include time spent staying in shelters and/or on the streets. , SQL Type: sqlTypeOther, nullable: true, editable: true)
AlcoholUseIndefinite (type: esriFieldTypeString, alias: Is the alcohol use indefinite and does it impede your ability to live independently?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
ChronicHealthCondition (type: esriFieldTypeString, alias: Do you have a diagnosed chronic health condition that has lasted more than three months?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
HealthConditionIndefinite (type: esriFieldTypeString, alias: Is the chronic health condition indefinite and does it impede your ability to live independently, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
DevelopmentalDisability (type: esriFieldTypeString, alias: Do you have a developmental disability, such as a learning disorder?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
DrugUse (type: esriFieldTypeString, alias: Do you use drugs that are illegal or prescription for non-medical reasons?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
DrugUseContinued (type: esriFieldTypeString, alias: Is the drug use indefinite and does it impede your ability to live independently?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
HIV (type: esriFieldTypeString, alias: Do you have AIDS or an HIV-related illness?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
MentalHealth (type: esriFieldTypeString, alias: Do you have a serious mental health condition such as depression, anxiety, PTSD or anything else?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
MentalHealthContinued (type: esriFieldTypeString, alias: Is the mental health condition indefinite and does it impede your ability to live independently?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
PhysicalDisability (type: esriFieldTypeString, alias: Do you have a physical disability?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
PhysicalDisabilityContinued (type: esriFieldTypeString, alias: Is the physical disability indefinite and does it impede your ability to live independently?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
DV (type: esriFieldTypeString, alias: Are you a survivor of domestic violence, dating violence, sexual assault, human trafficking, or stalking?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
DVContinued (type: esriFieldTypeString, alias: If yes, are you currently experiencing homelessness because you are fleeing one of those situations?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
Animal (type: esriFieldTypeString, alias: Do you have an animal with you that also needs services/housing? (i.e. service animal, emotional support animal, pet, etc.), SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)
AnimalContinued (type: esriFieldTypeString, alias: Does this animal limit your ability to access services/housing?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [DoesntKnow: Individual Doesn't Know], ... 1 more ...)