WIC Benefits Question Title * 1. Which foods do you purchase least often with your WIC benefits? (Please check all that apply.) Fruits and Vegetables Beans or peanut butter Milk WIC Cereal Whole Wheat Bread/Whole Grains Juice Eggs Other (please specify) Question Title * 2. Do you have any barriers that prevent you from getting your WIC card reloaded? Transportation Work schedule conflicts with WIC hours of operation None Other (please specify) Question Title * 3. Do you feel you would benefit from online or over-the-phone appointments? Yes No Not applicable Question Title * 4. It was found that WIC participants are not using their benefits to the fullest. Are there barriers that prevent you from purchasing specific foods? Please select all that apply. I don't have a way of getting to the store or WIC office. I am unsure of when to reload my card. I don't know how to use the WIC foods. I don't like the WIC food choices/brands offered. I don't know the WIC food choices I lost my card. I have allergies/health issues. I don't have time to prepare the foods. I have trouble using my card at the grocery store. I am embarrassed to shop with the eWIC card. I have too much of it already. I had a miscarriage. I don't need WIC services anymore. I have no barriers. Other (please specify) Question Title * 5. If WIC were to provide you with more information and recipes about the foods that you aren't purchasing, would you be more likely to purchase them? Yes No Maybe Question Title * 6. WIC is working on new, innovative ways to provide education and load your card. Please select the option that you prefer most: A phone conversation Online In person at the WIC office In person at the grocery store Question Title * 7. Please rank your preference of grocery stores within the area. (1 being most preferred, 9 being least preferred) 1 2 3 4 5 6 7 8 9 N/A Festival-Copeland N/A 1 2 3 4 5 6 7 8 9 N/A Festival-Village N/A 1 2 3 4 5 6 7 8 9 N/A Festival-Onalaska N/A 1 2 3 4 5 6 7 8 9 N/A Festival-Holmen N/A 1 2 3 4 5 6 7 8 9 N/A Wal-Mart South Side N/A 1 2 3 4 5 6 7 8 9 N/A Wal-Mart Onalaska N/A 1 2 3 4 5 6 7 8 9 N/A Woodman's N/A 1 2 3 4 5 6 7 8 9 N/A Gordy's N/A 1 2 3 4 5 6 7 8 9 N/A Indochinese N/A Question Title * 8. What days would you prefer to meet at the grocery store? Please rank. (1 being most preferred, 5 being least preferred) 1 2 3 4 5 Monday 1 2 3 4 5 Tuesday 1 2 3 4 5 Wednesday 1 2 3 4 5 Thursday 1 2 3 4 5 Friday Question Title * 9. What would be your preferred time to meet at the grocery store? 8 am - 11 am 11 am - 2 pm 2 pm - 5 pm Other (please specify) Question Title * 10. Is there anything else that you would like us to pass on to the WIC services? Yes (please put in comment box below) No Comments: Done