Screen Reader Mode Icon Check SCREEN READER MODE to make this survey compatible with screen readers. P.W.A Survey (English version) Question Title * 1. Which of our services are you accessing now during COVID-19? Select all that apply. Essentials Market Food Delivery Financial Assistance Harm Reduction Peer Support Wellness Check-in OK Question Title * 2. Which of the following do you prefer? Picking up a pre-made food bag. Shopping for the items that you want. OK Question Title * 3. Are there different services that you would like to see PWA provide during COVID-19? OK Question Title * 4. How frequently do you visit PWA? Every Week Every 2-3 weeks Every month Every 2-3 months Every 4-6 months Once or twice a year OK Question Title * 5. How would you rate your level of satisfaction with the PWA COVID-19 response? Highly satisfied Somewhat satisfied Neutral Somewhat dissatisfied Highly dissatisfied Highly satisfied Somewhat satisfied Neutral Somewhat dissatisfied Highly dissatisfied OK Question Title * 6. Please rate us on the following. Well Below Average Below Average Average Above Average Well Above Average Customer service Customer service Well Below Average Customer service Below Average Customer service Average Customer service Above Average Customer service Well Above Average Professionalism Professionalism Well Below Average Professionalism Below Average Professionalism Average Professionalism Above Average Professionalism Well Above Average Quality of service Quality of service Well Below Average Quality of service Below Average Quality of service Average Quality of service Above Average Quality of service Well Above Average Understanding your needs Understanding your needs Well Below Average Understanding your needs Below Average Understanding your needs Average Understanding your needs Above Average Understanding your needs Well Above Average Staff members Staff members Well Below Average Staff members Below Average Staff members Average Staff members Above Average Staff members Well Above Average Personal information Personal information Well Below Average Personal information Below Average Personal information Average Personal information Above Average Personal information Well Above Average OK Question Title * 7. How likely are you to continue using the services of the PWA? Very likely Somewhat likely Neutral Somewhat unlikely Very unlikely OK Question Title * 8. How likely is it that you would recommend our services? Very likely Somewhat likely Neutral Somewhat unlikely Very unlikely OK Question Title * 9. Do you have any suggestions for improving our services? OK Question Title * 10. During COVID-19, we had to make some adjustments to our delivery of services. What do you think we should keep and what do you think we should not keep? OK Question Title * 11. What are some of the items that you would like to see in your Essentials Market shopping bag? OK Question Title * 12. Share one positive experience which sticks in your mind about the PWA. OK Question Title * 13. Share one negative experience you've had with the PWA that lingers in your mind. OK Question Title * 14. How long have you been a client of the PWA? Less than 6 months 1-3 years 3-5 years 5 years or more OK Question Title * 15. How do you identify? Female Male Rather not say Trans man Trans woman OK Question Title * 16. Tell us about yourself, are you: Bisexual Gay Lesbian Straight/Heterosexual Two spirited Undisclosed OK Question Title * 17. Please tell us how you identify: Arab/West Asian Black First Nation Inuit Latin American Metes Not listed South Asian Southeast Asian White Other OK Question Title * 18. Which category describes your age? Younger that 18 18 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 or older Prefer not to answer OK Question Title * 19. If eligible, has PWA connected you to any government income support programs? Yes No OK Question Title * 20. If yes, (a) was the application process successful and effective? Yes No OK Question Title * 21. (b) did you receive all the required support to apply for the income support program? Yes No OK Question Title * 22. Do you have medical coverage from a private insurance or a government assistance program? Yes No OK Question Title * 23. Did PWA provide you with the information and appropriate support to apply for the medical coverage program? Yes No OK Question Title * 24. What are your views about the turn-around time in receiving the services you requested? OK Question Title * 25. What type of Peer Support have you received during the COVID-19 period? (Check all that apply) Well Below Average Below Average Average Above Average Well Above Average Telephone check in Telephone check in Well Below Average Telephone check in Below Average Telephone check in Average Telephone check in Above Average Telephone check in Well Above Average Other In-person support In-person support Well Below Average In-person support Below Average In-person support Average In-person support Above Average In-person support Well Above Average Other Translation services Translation services Well Below Average Translation services Below Average Translation services Average Translation services Above Average Translation services Well Above Average Other Food delivery Food delivery Well Below Average Food delivery Below Average Food delivery Average Food delivery Above Average Food delivery Well Above Average Other Referrals Referrals Well Below Average Referrals Below Average Referrals Average Referrals Above Average Referrals Well Above Average Other None None Well Below Average None Below Average None Average None Above Average None Well Above Average Other OK Question Title * 26. Are the services offered at PWA culturally appropriate to meet the needs of ethnically diverse populations? Yes No OK Question Title * 27. What can we do to make our services more culturally appropriate? OK Question Title * 28. Is there anything else that you would like to tell us? OK DONE
