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* 1. Which of our services are you accessing now during COVID-19? Select all that apply.

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* 2. Which of the following do you prefer?

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* 3. Are there different services that you would like to see PWA provide during COVID-19?

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* 4. How frequently do you visit PWA?

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* 5. How would you rate your level of satisfaction with the PWA COVID-19 response?

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* 6. Please rate us on the following.

  Well Below Average Below Average Average Above Average Well Above Average
Customer service
Professionalism
Quality of service
Understanding your needs
Staff members
Personal information

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* 7. How likely are you to continue using the services of the PWA?

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* 8. How likely is it that you would recommend our services?

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* 9. Do you have any suggestions for improving our services?

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* 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?

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* 11. What are some of the items that you would like to see in your Essentials Market shopping bag?

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* 12. Share one positive experience which sticks in your mind about the PWA.

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* 13. Share one negative experience you've had with the PWA that lingers in your mind.

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* 14. How long have you been a client of the PWA?

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* 15. How do you identify?

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* 16. Tell us about yourself, are you:

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* 17. Please tell us how you identify:

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* 18. Which category describes your age?

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* 19. If eligible, has PWA connected you to any government income support programs?

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* 20. If yes, (a) was the application process successful and effective?

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* 21. (b) did you receive all the required support to apply for the income support program?

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* 22. Do you have medical coverage from a private insurance or a government assistance program?

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* 23. Did PWA provide you with the information and appropriate support to apply for the medical coverage program?

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* 24. What are your views about the turn-around time in receiving the services you requested?

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* 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
In-person support
Translation services
Food delivery
Referrals
None

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* 26. Are the services offered at PWA culturally appropriate to meet the needs of ethnically diverse populations?

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* 27. What can we do to make our services more culturally appropriate?

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* 28. Is there anything else that you would like to tell us?

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