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* 1. My relationship to OIC is:
(Mi relación con la OIC es:)

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* 2. I participate in the following program(s) and/or service(s):
(Yo participo en los siguientes programas y/o servicios:)

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* 3. What is your race/ethnicity?
(¿Cuál es su raza/etnicidad)

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* 4. Age Range
(Edad)

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* 5. What is your gender?
(Género)

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* 6. Which OIC location(s) do you receive services at?
(¿En cuál oficina OIC recibe servicios?)

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* 7. It is easy to apply for programs and services.
(Es fácil aplicar para los programas y servicios.)

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* 8. OIC staff are helpful and courteous.
(El personal de OIC es amable.) 

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* 9. OIC staff helped me find other programs/services that could help me.
(El personal de OIC me ayudo a encontrar otros programas/servicios que pudieran ayudarme.)

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* 10. OIC programs have helped me change my life for the better.
(Los programas de OIC me han ayudado a mejorar mi vida.)

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* 11. What barrier(s) prevent you from accessing services? Check all that apply
(¿Qué obstáculos le impiden acceder a los servicios? )

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* 12. What other programs/services would you like OIC to provide?
(¿Qué otros programas/servicios le gustaría que proporcionara OIC?)

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* 13. Is there anything else you would like to share about your experience with OIC?
(¿Le gustaría compartir otra cosa sobre su experiencia con OIC?)

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* 14. How did you hear about us?
(¿Cómo te enteraste de nosotros?)

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