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Needs & Strengths Questions Test
Employment Questions
The following questions focus on current life circumstances and basic needs. Your answers will help us start a conversation about services that may help remove barriers and make finding employment easier.
Do you have reliable access to a computer/smart phone/ or similar device?
Never
Rarely
Sometimes
Often
Always
Do you have reliable access to internet?
Never
Rarely
Sometimes
Often
Always
Do you have reliable transportation for daily activities?
Never
Rarely
Sometimes
Often
Always
*Reliable transportation means you don’t have to worry about whether it will be available or not.
Are you comfortable reaching out to other community programs and supports?
Never
Rarely
Sometimes
Often
Always
Do you have responsibilities as a caregiver for any other persons in your life? Family with Disabilities, Elder, parent, childcare for other family members.
Never
Rarely
Sometimes
Often
Always
Do you have a role in the community or volunteer work that you fill on an ongoing basis? (Elder, Firekeeper, collecting/chopping wood, etc.)
Yes
No
Is there volunteer work within the community you are interested in?
Yes
No
Physical Health Question
Have you been diagnosed with any Health Concerns that may impede your ability to work or take schooling?
Yes
No
Housing
Is your current Housing Situation a priority?
Yes
No
What is your housing situation right now?
Couch surfing
Cannot afford current place
Housing requires repair
Overcrowding
Do you have any children?
Yes
No
Do you have any dependents under the age of 18
My Parenting and Children
Is your parenting a priority at this time?
Yes
No
Do you have time that allows you to develop yourself, undertake personal care and learn new skills?
Never
Rarely
Sometimes
Often
Always
Do you have childcare supports to assist you and give you parent relief or participate in activities?
Never
Rarely
Sometimes
Often
Always
Do you need financial supports for childcare?
Yes
No
Is there certain times of day that are better for you then others to participate in activities away from your children?
Education, Literacy and Essential Skills
In today’s age, skill development and upkeep of a skill needs to be done a regular basis, this section is designed to assist with understanding a person’s skill development.
I am comfortable reading and understanding written information. (hand written – typed)
Never
Rarely
Sometimes
Often
Always
I am comfortable communicating with my friends and family. (verbally)
Never
Rarely
Sometimes
Often
Always
I am comfortable using numbers to tally costs, create budgets, and work on financials.
Never
Rarely
Sometimes
Often
Always
I am comfortable using computers?
Never
Rarely
Sometimes
Often
Always
I am comfortable using a smartphone?
Never
Rarely
Sometimes
Often
Always
Do you know how to navigate the internet?
Never
Rarely
Sometimes
Often
Always
Volunteer and Community Work
This section explores your volunteer work both within and outside of the community.
Do you actively participate in your community events and activities?
Never
Rarely
Sometimes
Often
Always
Do you find yourself motivated by the volunteer work you do?
Never
Rarely
Sometimes
Often
Always
Did you receive training and ongoing training for the volunteer work you complete within your community?
Never
Rarely
Sometimes
Often
Always
How many hours per month do these activities require from you?
Please enter a number from
0
to
999
.
Life Wellness and Wellbeing
Are you engaging at community events?
Never
Rarely
Sometimes
Often
Always
Do you have someone supportive of you?
Never
Rarely
Sometimes
Often
Always
Are you willing to seek new experiences and learn?
Never
Rarely
Sometimes
Often
Always
Physical Health and Accessibility
This section looks at health and wellness limitations to participation in case management
Do you have any diagnosed health conditions?
Chronic Pain
Chronic Illness
Diabetes
Auto Immune Disease
Heart Disease
Cancer
Arthritis
Pregnancy
Mental Health Issues
Addictions
Other
Non – Disclosure
Do you have service providers who are assisting you with your condition/s?
Yes
No
Do you need a referral?
Yes
No
Have you ever been accessed for any additional conditions thru schools, hospitals etc? Do you have a copy of the assessment?
Yes
No
Do you believe you are getting enough rest?
Never
Rarely
Sometimes
Often
Always
Is your addiction preventing you from participating in programs and activities?
Never
Rarely
Sometimes
Often
Always
Do you require a referral to a service provider?
Yes
No
Mental Health
Is your current mental Health situation a priority?
Yes
No
Are you seeing a counsellor, therapist or medical personnel for your mental health issue?
Yes
No
Do you want a referral to support for your mental health?
Yes
No
Addiction Needs
Is your addiction preventing you from participating in programs and activities?
Never
Rarely
Sometimes
Often
Always
Are you working on your addiction with a health care professional, counsellor or healer?
Yes
No
Do you want a referral?
Yes
No
Culture and Community
This section explores your connection to your cultural roots.
Cultural activities and land based programs assist in my desire to live a good life?
Never
Rarely
Sometimes/Neutral
Often
Always
Land based includes – hunting, fishing, gathering, gardening and activities done on the land, lakes or oceans. Cultural activities include ceremonies, language, dance, arts, medicine gathering, sweats and other activities that are culture based.
I feel comforted when I participate in cultural activities and ceremonies.
Never
Rarely
Sometimes/Neutral
Often
Always
My cultural and religious identity is important to me.
Never
Rarely
Sometimes/Neutral
Often
Always
Ceremonies and cultural activities open me up to share my thoughts and feelings with others.
Never
Rarely
Sometimes/Neutral
Often
Always
I take initiative and attend land-based activities.
Never
Rarely
Sometimes/Neutral
Often
Always
Connection to land and water enhance my identity.
Never
Rarely
Sometimes/Neutral
Often
Always
Hunting, fishing and gathering are part of my life?
Never
Rarely
Sometimes/Neutral
Often
Always
I can find the cultural supports and land based activities I require locally?
Yes
No
Where do you find cultural supports and land based activities?
I would like to attend more cultural and land based programming?
Yes
No
What cultural and land based programming would you like to attend?
I have connections to other First Nations communities?
Yes
No
Which First Nation communities do you have connections to?
