Respondent_Identification (type: esriFieldTypeString, alias: Please select one of the following:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Youth: I am a young person filling out this form.], [Service provider: I am a service provider filling out this form on behalf of a young person.])
Intake_assessment_complete (type: esriFieldTypeString, alias: Did the young person complete the Intake Assessment?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes, they completed the assessment.], [No: No, they did not complete or declined completing the assessment.])
Exit_assessment_complete (type: esriFieldTypeString, alias: Did the young person complete the Exit Assessment? , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes, they completed the assessment.], [No: No, they did not complete or declined completing the assessment.])
SCO_assessment_complete (type: esriFieldTypeString, alias: Did the young person complete the Single Contact Only Assessment? , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes, they completed the assessment.], [No: No, they did not complete or declined completing the assessment.])
ydn_region (type: esriFieldTypeString, alias: YDN Region, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Antelope Valley: Antelope Valley], [East Los Angeles: East Los Angeles], [South Los Angeles: South Los Angeles], ... 2 more ...)
service_provider_AV (type: esriFieldTypeString, alias: Service Provider - AV, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Antelope Valley Community Uplif: Antelope Valley Community Uplift Foundation ], [Project Joy: Project Joy ], [Right Solutions: Right Solutions], ... 4 more ...)
service_provider_ELA (type: esriFieldTypeString, alias: Service Provider - ELA, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Jail Guitar Doors: Jail Guitar Doors], [Peace Over Violence: Peace Over Violence], [826LA: 826LA], ... 4 more ...)
service_provider_SLA (type: esriFieldTypeString, alias: Service Provider - SLA, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [A Place Called Home: A Place Called Home], [Youth Justice Coalition: Youth Justice Coalition ], [LA Commons Community Partners: LA Commons Community Partners], ... 6 more ...)
service_provider_LB (type: esriFieldTypeString, alias: Service Provider - LB, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Children's Institute: Children's Institute], [Boss, Inc.: Boss, Inc. ], [Do Good Daniels Family Foundati: Do Good Daniels Family Foundation ], ... 3 more ...)
service_provider_SFV (type: esriFieldTypeString, alias: Service Provider - San Fernando Valley, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [CHIRLA: CHIRLA], [Arts for Healing and Justice Ne: Arts for Healing and Justice Network (AHJN)], [Hands for Hope: Hands for Hope ], ... 2 more ...)
Gender_identity (type: esriFieldTypeString, alias: What is your current gender identity?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
gender_other (type: esriFieldTypeString, alias: Other - What is your current gender identity?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Sex (type: esriFieldTypeString, alias: What is your sex designated or listed at birth?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Male: Male], [Female: Female], [X (genderqueer, nonbinary): X (genderqueer, nonbinary)], ... 2 more ...)
sex_other (type: esriFieldTypeString, alias: Other - What is your sex designated or listed at birth?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Sexual_orientation (type: esriFieldTypeString, alias: Do you think of yourself as:, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
sexual_orientation_other (type: esriFieldTypeString, alias: Other - Do you think of yourself as:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Race (type: esriFieldTypeString, alias: What is your race? , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [American Indian or Alaska Nativ: American Indian or Alaska Native], [Asian: Asian], [Black or African American: Black or African American], ... 5 more ...)
race_other (type: esriFieldTypeString, alias: Other - What is your race? , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Multi_ethnic (type: esriFieldTypeString, alias: Are you multi-ethnic?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [Decline to respond: Decline to respond])
Hispanic_or_Latino (type: esriFieldTypeString, alias: Do you identify as Hispanic or Latino?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [Decline to respond: Decline to respond])
Ethnicity_Hispanic_Latino (type: esriFieldTypeString, alias: What is your ethnicity?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Caribbean: Caribbean], [Central American: Central American], [Mexican/Mexican-American/Chican: Mexican/Mexican-American/Chicano], ... 4 more ...)
ethnicity_hispanic_other (type: esriFieldTypeString, alias: Other - What is your ethnicity?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Ethnicity_Non_Hispanic_Latino (type: esriFieldTypeString, alias: What is your ethnicity?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [African: African], [Asian Indian/South Asian: Asian Indian/South Asian], [Cambodian: Cambodian], ... 10 more ...)
ethnicity_nonhispanic_other (type: esriFieldTypeString, alias: Other - What is your ethnicity?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Language (type: esriFieldTypeString, alias: Which language do you most often speak at home?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Arabic: Arabic], [Armenian: Armenian], [Cambodian: Cambodian], ... 14 more ...)
language_other (type: esriFieldTypeString, alias: Other - Which language do you most often speak at home?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Disability (type: esriFieldTypeString, alias: Do you have a disability?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [Decline to respond: Decline to respond])
Disability_type (type: esriFieldTypeString, alias: What type of disability do you have?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
disability_other (type: esriFieldTypeString, alias: Other - What type of disability do you have?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Veteran (type: esriFieldTypeString, alias: Are you a veteran?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No], [Decline to respond: Decline to respond])
SC_YDN_services (type: esriFieldTypeString, alias: Which of the following free services did you receive through the Youth Development Network today?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
Other (type: esriFieldTypeString, alias: Other - Which of the following free services did you receive through the Youth Development Network today?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
SC_Unfulfilled_YDN_services (type: esriFieldTypeString, alias: Were there any additional services that you would have liked to receive through your local YDN but didn’t receive? , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
SC_Adtnl_YDN_services (type: esriFieldTypeString, alias: Please identify the types of services you would have liked to receive., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
SC_System_Involvement (type: esriFieldTypeString, alias: As of today, I have been involved with the following:, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
SC_system_other (type: esriFieldTypeString, alias: Other - As of today, I have been involved with the following:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
SC_Living_Situation (type: esriFieldTypeString, alias: Which of the following best describes your current living situation?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
sc_living_situation_other (type: esriFieldTypeString, alias: Other - Which of the following best describes your current living situation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
sc_awareness (type: esriFieldTypeString, alias: Please share how much you agree or disagree with the following statement on the scale below:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [Somewhat: Somewhat], [No: No])
SC_recommend_YDN (type: esriFieldTypeString, alias: “I would recommend connecting with Youth Development Network resources to one of my friends.", SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
SC_fulfilled_support (type: esriFieldTypeString, alias: “I feel like I got the support I needed.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
SC_satisfaction (type: esriFieldTypeString, alias: “Overall, I feel satisfied about my experience.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
SC_Feedback (type: esriFieldTypeString, alias: Please share any feedback if you'd like., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
entry_social_support_cnctdness (type: esriFieldTypeString, alias: “I feel like part of a community.” , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
entry_confidence_belonging (type: esriFieldTypeString, alias: "I know if I keep working at something, I will get better at it.” , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
entry_social_competence (type: esriFieldTypeString, alias: “I know at least one thing I can do to deal with difficult thoughts.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
entry_concrete_supports (type: esriFieldTypeString, alias: “I know about resources that might be helpful for me or someone I care about.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
entry_mentor_relationship (type: esriFieldTypeString, alias: “I have someone in my life who is a mentor or guide.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
binary_current_services (type: esriFieldTypeString, alias: Are you currently participating in any programs or supportive services in your community?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
Entry_Current_services (type: esriFieldTypeString, alias: Which of the following programs or supportive services are you currently part of?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
Current_services_other (type: esriFieldTypeString, alias: Other - Which of the following programs or supportive services are you currently part of?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Entry_YDN_Services (type: esriFieldTypeString, alias: Which of the following free services would you like to receive through the Youth Development Network?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
YDN_services_other (type: esriFieldTypeString, alias: Other - Which of the following free services would you like to receive through the Youth Development Network?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Entry_Goals (type: esriFieldTypeString, alias: What goal(s) would you like to work on together to build your strengths and meet your needs?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
Goals_Other (type: esriFieldTypeString, alias: Other - What goal(s) would you like to work on together to build your strengths and meet your needs?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
entry_awareness (type: esriFieldTypeString, alias: Please share how much you agree or disagree with the following statement on the scale below:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [Somewhat: Somewhat], [No: No])
Entry_System_involvement (type: esriFieldTypeString, alias: As of today, I have been involved with the following:, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
Entry_system_other (type: esriFieldTypeString, alias: Other - As of today, I have been involved with the following:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Entry_Living_Situation (type: esriFieldTypeString, alias: Which of the following best describes your current living situation?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
entry_living_other (type: esriFieldTypeString, alias: Other - Which of the following best describes your current living situation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
exit_social_support_conctdness (type: esriFieldTypeString, alias: “I feel like part of a community.” , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
exit_confidence_belonging (type: esriFieldTypeString, alias: "I know if I keep working at something, I will get better at it.” , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
exit_social_competence (type: esriFieldTypeString, alias: “I know at least one thing I can do to deal with difficult thoughts.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
exit_concrete_supports (type: esriFieldTypeString, alias: “I know about resources that might be helpful for me or someone I care about.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
exit_mentor_relationship (type: esriFieldTypeString, alias: “I have someone in my life who is a mentor or guide.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
Exit_YDN_services (type: esriFieldTypeString, alias: Which of the following free services did you receive through the Youth Development Network? , SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
Exit_YDN_services_other (type: esriFieldTypeString, alias: Other - Which of the following free services did you receive through the Youth Development Network? , SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
Exit_Living_Situation (type: esriFieldTypeString, alias: Which of the following best describes your current living situation?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
exit_living_other (type: esriFieldTypeString, alias: Other - Which of the following best describes your current living situation?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
exit_awareness (type: esriFieldTypeString, alias: Please share how much you agree or disagree with the following statement on the scale below:, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [Somewhat: Somewhat], [No: No])
exit_recommend_YDN (type: esriFieldTypeString, alias: “I would recommend connecting with Youth Development Network resources to one of my friends.", SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
exit_fulfilled_support (type: esriFieldTypeString, alias: “I feel like I got the support I needed.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
exit_accomplish_goals (type: esriFieldTypeString, alias: “I feel like I accomplished my goals.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
exit_satisfaction (type: esriFieldTypeString, alias: “Overall, I feel satisfied about my experience.”, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Strongly Disagree: Strongly Disagree], [Disagree: Disagree], [Neutral: Neutral], ... 2 more ...)
Exit_feedback (type: esriFieldTypeString, alias: Please share any feedback if you'd like., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
early_exit_YDN_services (type: esriFieldTypeString, alias: Which of the following services did the youth receive through the Youth Development Network?, SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
early_exit_services_other (type: esriFieldTypeString, alias: Other - Which of the following services did the youth receive through the Youth Development Network?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true)
early_exit_feedback (type: esriFieldTypeString, alias: Please share any information about the young person's early exit from the YDN Program., SQL Type: sqlTypeOther, length: 1000, nullable: true, editable: true)
have_you_completed_this_survey (type: esriFieldTypeString, alias: Have you completed this survey for other YDN services you have received in the past?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
do_you_have_the_youths_consent (type: esriFieldTypeString, alias: Do you have the youth's consent on file?, SQL Type: sqlTypeOther, length: 255, nullable: true, editable: true, Coded Values: [Yes: Yes], [No: No])
Templates:
Name: New Feature
Description:
Drawing Tool: esriFeatureEditToolNone
Prototype: