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Housing Survey

If you live in New York State and you or a family member are considering moving into an agency run residence, renting an apartment or buying your first home, please take a few minutes to fill out this survey.  The data will be compiled and shared with people around the state to highlight the housing desires, needs and barriers for people with disabilities.



What county of New York State do you reside in now?


When are you planning on buying or renting?  

Where would you like to live? (Select all that apply.)
City Suburb Rural

If these options were available, which one would you choose?
Agency run residence Rental Buy house Mobile Home

What modifications would you need?
None Physical Environmental
Other, explain:

What specific housing needs do you have?
Wheelchair accessibility
Pet accommodating
Close to bus line
Visual door bell
"Visit"ability
Housing advisor or counselor
Aide services
Housemate
Support staff
Other, please explain:

If you are considering an agency run residence, what is important to you in making your decision:  (check any that apply)
A bedroom of my own (no roommates)
Input into choosing my housemates
A home close to my family
A home in the neighborhood of my choice
An agency who would work with me and my family on an OPTS proposal
Other; please explain:


If you are considering renting, what is important to you in making your decision? (check any that apply)
Affordable
Close to my family
Neighborhood of my choice
First floor apartment
Elevator
Apartment Manager/Management
Other, please explain:

If you are considering buying your first home, what is important to you: (check all that apply)
Affordable
Close to my family
It is a ranch style home
Upkeep/maintenance
Working with a realtor who understands my needs and the ADA regulations
Other, please explain:

What do you feel are obstacles to achieving your housing dream?
I don't know where to start
Discrimination
My credit history is poor
I have no credit history
I need help paying the rent
I don't have a security deposit for an apartment
I don't have enough money for a down payment on a home
I don't have enough money for closing costs
I can't afford a house payment
I need help reading and/or filling out paperwork
I need a personal aide
Other; please explain: 

Additional comments:


Your email address:






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