NYS Poor People's Campaign - Healthcare and Housing Outreach Survey
The fact that there are 140 million poor and low-wealth people in a country this rich is morally indefensible. In New York, there are 112 billionaires and over a million millionaires yet over half of New Yorkers cannot access the healthcare we need and each night, 500,000 are homeless.

Everybody has a right to live. Everybody has a right to safe housing and high-quality healthcare.

Please share your Healthcare and Housing Story with the NYS Poor People’s Campaign.
Español: https://forms.gle/niJi963BV2gh9UQa6 
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How will my responses be used?
Our stories are our most powerful tools for building a movement to transform society. Respondents will be encouraged to share their stories with the public and lawmakers as part of efforts to pass laws to expand access to healthcare and housing in New York. At the end of the questionnaire please indicate how you would like to be involved.

1) How have you been impacted by the Coronavirus pandemic?
2) Are you concerned about the impacts of your housing on your health? (Due to any factor such as lead, smoke, stress, water, mold, abusive or predatory landlord, racist housing)
Clear selection
2b) If yes, can you explain what happened?
3) Have you faced difficulty accessing or paying for healthcare, housing, food, or transportation?
Clear selection
3b) If yes, can you explain what happened?
4) Have any of your health needs (physical, social/emotional, costs of care) interfered with your ability to get stable housing?
Clear selection
4b) If yes, can you explain what happened?
The Right to Healthcare
5) Have you ever delayed or had difficulty paying for any of the following types of care:
6) Have you or someone in your family experienced any of the following:
6b) Can you share about any Yes answers above?
7) How would your life change if healthcare were guaranteed and cost were not a concern?
The Right to Housing
8) Have you had to move due to housing costs, predatory landlord behavior, or unsafe living conditions?
Clear selection
9) Have you been subjected to discrimination in accessing housing because of your race, immigration status, gender, sexual orientation, age or disability?
Clear selection
10) What do you think is the biggest obstacle to getting stable housing for everyone in New York State?
The NYS Poor People's Campaign
Please answer a few more questions so we know how you would like to be involved in the Poor People’s campaign.
Would you like to get more involved in the NYS Poor People’s Campaign?
Clear selection
If you answer Yes, please share your contact information so that organizers with the NYS Poor People's Campaign can followup with you.
First Name *
Last Name *
Phone *
Email *
Address
Zip Code *
Are you part of a community organization, union, or faith community?
Clear selection
If you answered yes, what organization?
What's the best way to contact you?
Clear selection
Would you be willing to speak with the media, lawmakers, and others about your story?
Clear selection
Any additional comments you would like to make?
Submit
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