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1-Month Follow-Up (Optional)

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About

Uploaded by: Makerble Templates
Number the questions (only when viewed internally)

Section 1: Housing Status

Q1. Still in Accommodation at 1 Month (single choice)

Question Settings ▼ ▲

Are you still in the accommodation you moved to?

Yes No

Dropdown List used: Still in Accommodation at 1 Month

Q2. Current Housing Status (single choice)
Hidden Unless No is selected in Q2 Still in Accommodation at 1 Month

Question Settings ▼ ▲

What is your current housing situation?

Same accommodation Different accommodation (still housed) Rough sleeping Staying with friends/family Other emergency accommodation In treatment facility In custody Unknown

Dropdown List used: Current Housing Status

Q3. Nights Slept Rough (single choice)

Question Settings ▼ ▲
Yes No

Dropdown List used: Nights Slept Rough

Section 2: Wellbeing Check

Q4. Physical Health Perception (single choice)

Question Settings ▼ ▲

How would you rate your physical health right now?

1 2 3 4 5 6 7 8 9 10

Dropdown List used: Physical Health Perception

Q5. Mental Wellbeing (single choice)

Question Settings ▼ ▲

How would you rate your mental health and wellbeing right now?

1 2 3 4 5 6 7 8 9 10

Dropdown List used: Physical Health

Q6. Level of Support Needed (single choice)

Question Settings ▼ ▲

How much support do you currently need to maintain your housing?

Intensive daily support Regular support (weekly) Occasional support (monthly) Low-level support No support needed

Dropdown List used: Level of Support Needed

Section 3: Support Needs

Q7. Do you need any additional support right now? (single choice)

Question Settings ▼ ▲

Do you need any additional support right now?

Yes No

Dropdown List used: Do you need any additional support right now?

Q8. What would be helpful? (Text)
This question will appear once within your story or survey response.

Collect survey responses

360°
360°
Invite observers to answer a survey about a contact in your CRM. Send out invitations for several contacts at once via email, SMS or your own channels.

Collect Responses

Universal
Universal
Allow anyone with the link to submit a survey response.
Optionally generate a QR code.
Share Link

Tracked
Tracked
Track responses to individual contacts. Send survey invitations via email and SMS - with automated reminders - or your own communication channels.
Collect Responses

Anonymised
Anonymised
Hide the identity of each respondent when collecting responses from saved contacts or a list of email addresses.
Collect Responses

Import
Import
Upload survey responses from a spreadsheet with a row per respondent and column per question.
Import Responses

API
API
Send out survey invitations programmatically and/or receive responses via the API..
Get Started

Filled in by a Colleague: 1 contact at a time
Filled in by a Colleague: 1 contact at a time
Submit a survey response about a saved contact while filling in a survey in-person (CAPI), over the phone (CATI) or typing up a paper survey response.
Collect Response

Filled in by a Colleague: Several at once
Filled in by a Colleague: Several at once
Use the Answers Table to submit responses to each question. There’s one row per contact. Responses are automatically linked to individual contacts.
Enter Responses

Filled in by a Colleague: Manual Headcount
Filled in by a Colleague: Manual Headcount
Enter responses without the need for individual contacts or respondents. Enter the number of people who gave each answer to each question.
Enter Quantities

Universal Manual Headcount
Universal Manual Headcount
Collect manual headcount responses from anyone with the link.

Share Link

Multi-stage
Multi-stage
Collect demographic data. Thread several surveys together. Deliver advanced survey experiences.
Go to Signup Pages

Branded Portal
Branded Portal
Provide respondents with a password-protected space to submit, review, discuss or act upon survey responses.
Get Started

Automation
Automation
Automatically send out survey invitations whenever certain rules are met
Create an automation

360° Assessment
360° Assessment
Get a rounded view of each contact by combining their self-reflections (Tracked), perspectives from people who know them (Observers) and your colleagues' professional opinions (Filled in by a Colleague). Send invitations for several contacts at once by email, SMS or your own channels.

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