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Needs Assessment

Aloha, we are community residents trying to help each other. The following questions are designed to help us better understand where help is needed most. Please take a few moments and complete this needs assessment so we can connect the people in our community with the resources they require.

Personal Info
What is your preferred language?
What is your preferred method of communication?
What race best describes you?
Do you live in West Maui now? (If yes, where?)
If no, in what region of the island do you live?
Resources and Services
What resources and services do you need to aid in your recovery? Please select all that apply.
Housing
Did you own a home in the fire impact zone?
Do you have a mortgage on a home in the fire impact zone?
Are you paying rent as a result of being displaced by the fires?
Employment
Did you own or work in a business that was in a fire impact zone?
Were you laid off as a result of the fires?
Are you currently employed?
If yes, did your work commute increase due to the fires?
Did you change jobs as a result of the fires?

Thanks for submitting!

Needs Assessment 

Aloha, we are community residents trying to help each other.  The following questions are designed to help us better understand where help is needed most.  Please take a few moments and complete this needs assessment so we can connect the people in our community with the resources they require. 

Personal Info

What is your preferred language?
What is your preferred method of communication?
What race best describes you?
What gender do yo identify as?
Do you live in West Maui? (If yes, where?)
If no, in what region of the island do you live?
Do yo have a safe place to stay post fire?
Have you experienced physical, verbal, or sexual violence while displaced from the fires?

Resources and Services

What resources and services do you need to aid in your recovery? Please select all that apply.

Housing

Did you own a home in the fire impact zone?
Do you have a mortgage on a home in the fire impact zone?
If yes, has your mortgage lender provided any relief?
Are you paying rent as a result of being displaced by the fires?
If yes, did you sign a lease?

Employment

Did you own or work in a business that was in a fire impact zone?
Were you laid off as a result of the fires?
Are you currently employed?
If yes, did your work commute increase due to the fires?
Did you change jobs as a result of the fires?

Thanks for submitting!

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