Region 5 Recovery Hub Individual Needs Assessment Survey Question Title * 1. Are you currently in recovery? Yes No Question Title * 2. Please identify how many months you have been in recovery. Question Title * 3. Have you received recovery support services in the past year? Yes No Question Title * 4. Are you currently receiving recovery support services? (If yes, please describe below) Yes No If you are currently receiving recover support services please describe them here: Question Title * 5. Are you currently seeking recovery support services? (If yes, please describe the services you are seeking.) Yes No Please describe the services you are currently seeking. Question Title * 6. Did you face challenges when entering recovery? (If yes, please describe below.) Yes (Please describe below) No Please describe challenges or barriers faced. Question Title * 7. Have you faced challenges staying in recovery? (If yes, please describe below) Yes (Please describe below) No Please describe challenges or barriers faced. Question Title * 8. What types of recovery support services have you used? Select all that apply. If other please describe below. Peer support Educational workshops Substance use counseling Employment assistance Housing assistance Legal services Other Other (please specify) Question Title * 9. Please rate your agreement to the following statement: There are enough recovery support services available to me. Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree Question Title * 10. Please rate your agreement to the following statement: Recovery support services are easily accessible for me. Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree Question Title * 11. Please rate your agreement to the following statement: There are a variety of support recovery services available to me Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree Question Title * 12. Please rate your agreement to the following statement: Access to recovery support services is equitable (e.g., everybody has fair and equal access). Strongly Agree Agree Neither Agree nor Disagree Disagree Strongly Disagree Question Title * 13. Please rate the quality of the services available to you. Very High High Neither High nor Low Low Very Low Question Title * 14. What has been the most helpful aspect of the recovery support services for you? Question Title * 15. In what areas do you think improvements are needed in the recovery support services? Select all that apply. If other please describe. Availability of services Quality of services Access to information about services Support for employment Support for housing Legal support Other Other (please specify) Question Title * 16. Do you feel that the recovery support services are culturally and linguistically appropriate? Yes No Not sure Question Title * 17. What additional support or services would you find helpful in your recovery journey? Question Title * 18. Which county do/did you receive your recovery support services in? Adams Bedford Blair Cumberland Dauphin Franklin Fulton Huntingdon Juniata Lebanon Mifflin Perry York Other/Prefer not to say Question Title * 19. How do you identify? Male Female Other (please specify) Question Title * 20. Are you a part of the LGBTQIA+ community? Yes No Question Title * 21. Which category below includes your age? Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 22. Please indicate your race American Indian Asian or Asian American Black or African American Native Hawaiian or other Pacific Islander White Other (please specify) Question Title * 23. Are you of Hispanic or Latino/a origin? Yes No Question Title * 24. What is your marital status? Single/Never Married Married In a domestic partnership Seperated Divorced Widowed Other (please specify) Question Title * 25. What is the highest level of school you have completed or the highest degree you havereceived? Less than high school degree High school degree or equivalent (e.g., GED) Some college but no degree Associate degree Bachelor degree Graduate degree Question Title * 26. Which of the following categories best describes your employment status? Full-time (working 40 or more hours per week) Part-time (working one to 39 hours per week) Seasonal work Not employed, looking for work Not employed, NOT looking for work Retired Disabled, not able to work Other (please specify) Question Title * 27. How much total combined money did all members of your household earn in 2022? $0-$9,999 $10,000-$19,999 $20,000-$29,999 $30,000-$39,999 $40,000-$49,000 $50,000-$59,999 $60,000-$69,999 $70,000-$79,000 $80,000-$89,000 $90,000-$99,999 $100,000 or more Question Title * 28. Please share any other comments or suggestions you have about the recovery support services. Done