Survey and Questionaire
The information gathered from this questionaire is a valuable and important assessment tool to help us better understand the needs, desires and concerns of our local/regional LGBT populations as it relates to establishing a full-time LGBT community center and programming ideas. Please take a few moments of your time to check each box as you feel is appropriate and turn your speakers on! For your listening enjoyment, Annie Lennox`s "Here comes the rain again" will be playing to help pass the time while you fill out this form. It shouldn`t take more than two or three minutes. Thank you so much for your help and your involvement! Have you ever visited an LGBT community center?
Yes
No
Was it something you`d like to see in our region?
Yes
No
Would you like to be an active member in The Bridge LGBT community center?
Yes
No
What would be most convenient for you to visit or utilize The Bridge community center when we are open full-time?
Days
Evenings
Weekends daytime
Weekends evenings
Our LGBT teens need a community center to offer them a safe space to meet and socialize. Do you agree?
Strongly agree
Agree
Disagree
Would you be willing to volunteer as a `youth mentor`?
Yes
Most likely
I`d consider this opportunity
No
If YES to the above question, do you have experience mentoring young folx?
Yes
Definately. Get real, I have children!
No life experience with youth [besides the given that I was a "youth" myself!], but I`m still interested none-the-less in mentoring
Are adult gay, lesbian and/or transgender discussion groups something you`d like to have available?
Yes
No
Gay Discussion groups?
Bisexual Discussion groups?
Lesbian Discussion groups
Transgender Discussion groups?
Have you had difficulties dealing with either your physical and/or mental healthcare provider due to your sexual orientation or gender expression?
Yes
Sometimes
Never
Don`t know
If Yes to the above, was it a mental healthcare or physical healcare provider?
Mental Healthcare
Physical Healthcare
Both
Is a supportive group for LGBT `dual-diagnosed` clients dealing with both drugs/alcohol and mental health issues of interest to you?
Yes
Yes, but not for myself
No
Is a supportive group for LGBT folx dealing with only mental health issues of interest to you?
Yes
No
It should be offered
Are "coming out" support groups for all ages needed?
Yes
Probably for some
No, not for me
Yes, for me
Because all supportive groups offered would be voluntarilly facilitated by members of that group, would you consider facilitating?
Yes
Maybe
Not sure
No
*If offered at The Bridge, would an alcohol-free juice bar and socials be of interest to you?
Yes
No
If offered, would you attend Recovery meetings for our LGBT populations at The Bridge?
Yes
Maybe
No
Are you currently active in any local-regional LGBT communities
Yes
Sometimes
No
I`d like to be more involved
Would you offer to volunteer at some point in time for The Bridge?
Yes
Sometimes
No
As a professional, would you be able to donate your professional service[s] to assist The Bridge organization? {ie: lawyer, CPA, educator, Grant Writer etc}
Yes
Sometimes
No
Did you have a positive `coming out` experience?
Yes
No
Do you identify as:
Gay
Lesbian
Bisexual
Transgender Female
Gender-Variant
Heterosexual
Gender Queer
Questioning
Transgender Male
Your age:
13 to 17
18 to 30
31 to 55
56 or older
Forever young!
