Your anonymous* and confidential feedback is important for improving 'As You Like It’. By completing this survey about your experience, you help us better serve you. If you have any urgent needs or would like an interpreter or accommodation, please call us at 207-396-6500. Thank you for your time and commitment to our community. You're an essential part of our Nutrition family!

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* 1. Your age range:

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* 2. Your gender identity:

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* 3. Your race:

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* 4. Household size:

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* 5. Household income level:

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* 6. Your education level:

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* 7. Your marital status:

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* 8. Town where you live:

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* 9. How did you learn about the ‘As You Like It’ program?

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* 10. How likely are you to recommend the ‘As You Like It’ program to others?

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* 11. Did you feel you were treated fairly and respectfully by staff regardless of age, race, gender identity, religion, income level, or other personal characteristics?

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* 12. How frequently do you attend an ‘As You Like It’ restaurant?

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* 13. Why do you participate in the ‘As You Like It’ program? (Please choose any that apply)

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* 14. The meals received at the ‘As You Like It’ restaurant(s) are an important source of nutritious food:

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* 15. How has participating in the ‘As You Like It’ program affected your overall health and well-being?

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* 16. How often do you feel you lack companionship?

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* 17. How often do you feel left out?

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* 18. How often do you feel isolated from others?

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* 19. I feel that participating in the 'As You Like It' program has helped me feel more socially connected.

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* 20. How would you rate the quality of the meals that you have been receiving in the ‘As You Like It’ restaurants?

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* 21. Where do you typically purchase your 'As You Like It’ meals?

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* 22. How would you rate the convenience of purchasing ‘As You Like It’ meals?

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* 23. What are your favorite ‘As You Like It’ restaurants?

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* 24. What other cafes or restaurants would you like to see added to our selection of ‘As You Like It’ restaurants? (Please note- all restaurants must meet certain guidelines to be added to the program).

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* 25. Have you faced any challenges when trying to find programs that match your cultural needs? If yes, please explain.

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* 26. Please share any additional comments or suggestions you have for improving ‘As You Like It’.

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* 27. *By providing your name and phone number, you consent to waive your anonymity. However, rest assured that your responses will remain confidential.

Thanks for helping us improve ‘As You Like It’! Your feedback matters. Your responses help shape our services. If you have any urgent needs, please call us at 207-396-6500. We appreciate your support!

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