S A H A R A   S U R V E Y

 
Please fill out the following questionaire, it will only take 5 minutes but will help many lives. This will help SAHARA identify the needs of the South Asian community, so we can target our referral services and programs toward serving you better.

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Survey

We hypothesize that Indo-Americans as seniors, youths, parents, immigrants face many personal, legal, medical, family/relationship, alcohol, psychological and many other 'never talked about' issues that the cultural bounds and American lifestyles have put on us. We need to hear directly from you about your experiences and your views on how our quality of life and health may be enhanced.

Your responses will be anonymous and completely confidential, and all results will be combined in such a way that no individual may be identified. This is your chance to communicate to us what kind of problems you think Indo-Americans face, so we can help the next person who faces that same problem!

1. Sex
2. Birthdate Month Year
3. Marital Status
4. Do you have any children? If so, how many?
5. Years of Schooling:
6. Where were you born:
7. How long have you been in the United States:
8. What is your NATIVE Language?
9. How would you rate your current health status? 
Personal needs:
10. Have you ever seeked counseling or any referral service? 
11. Have you ever been in a situation in which counseling might have helped?
12. Are there some problems you personally feel that you have not found help for?
 
Family needs:
13. Have you known anyone in 'distressful' family situations in which they could have used support?
Indian Community needs:
14. What do you perceive as the major strengths of the Indian Community?
15. What do you perceive as the major problems and needs of the Indian Community?
a. Do you think seniors in our community face special challenges?    

If yes, please explain
b. Do you think an Indo-American youth faces special challenges?
If yes, please explain
16. Did you know of SAHARA "South Asian Helpline And Referral Agency" before today?

To complete the survey please click submit below.

If you would like to help SAHARA, a non-profit organization that works to improve the quality of life of the South Asian community, you can:

  • Contact us at (562) 402-4132 or write to us
  • Become a volunteer for SAHARA
  • Make a donation (and mail to the following address)
  • Be on our mailing list (to receive our events information)

To be on our mailing list, please complete the following information

Name: Firstname, Lastname
Address: Street
City
State
Zip/Postcode
Country

 
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