RHYS RHYS Enter What is your HFY Number?How do you identify your gender?*AgenderFemaleGender FluidMalePangenderPrefer not to sayQuestioningTransgenderWhat is your age?*12-1515-1818-21How do you identify your race?*AsianBlack/African AmericanHispanicMultiracialNative AmericanNative Hawaiian/Pacific IslanderWhite/CaucasianOtherWhere did you stay last night?*At the home of parent, guardian or foster parentAt the home of a friend- indoors, on a couch or in place meant for regular sleepingAt the home of a relative - indoors, on a couch or in place meant for regular sleepingStayed outdoors or in a public place, like a park, the street, a campground, a train or bus station, etc.Stayed at the home of their partner, boyfriend, or girlfriend;Stayed at a youth or adult shelterStayed at a transitional living programStayed at a hotel/motel paid for by a government program or nonprofit organizationStayed in an abandoned building or squattedStayed in a car, train, bus, or RV;How long have you been staying there?*DaysWeeksMonthsYearsHow long have you been without a home, or a regular place to stay?*DaysWeeksMonthsYearsHow often have you gone without food?*Skipped a meal here & thereWent an entire day with out foodCan't remember the last time I ateWhat town were you living in before coming to our shelter?*What School/School District do you attend?*Thinking about the past 3 years, how many different times have you been without a home, or a regular place to stay?*01-34-1011-50What were the reason(s) for your change in living situation?*Ran Away/Kicked out from your family homeRan away/kicked out from a group home or foster homeViolence at home between family membersDifference with parents about religious beliefsMade a life or identity change & was told to leave homeLeft home because of some other reasonHave you ever been in foster care?*YesNoIn the past 30 days, have you used/taken drugs?*YesNoIn the past 30 days, have you drank alcohol?YesNoI often experience feelings of sadness, depression or anxiety.DisagreeNeither Disagree or AgreeAgreeI have been asked to participate in sexual activities in exchange for money, a place to stay or material itemsDisagreeNeither Disagree or AgreeAgreeDo you know of any other homeless youth?YesNoIf you answered yes, where are they located?Share more about your story with us:Which social media handle do you use to communicate?* Facebook Instagram Snap Chat WhatsApp Twitter GroupMe kik Facebook Messenger