Client Survey

AAC Food Bank Client Survey

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* 1. How many people are in your household?

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* 2. How many children are in your household?

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* 3. Does anyone in your household have allergies?

Yes

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* 4. if Yes, please explain?

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* 5. How many pantries/soup kitchens have you had to go to in a month?

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* 6. Are the food quantities enough?

Yes

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* 7. Your overall visit experience

dissatisfied

satisfied

dissatisfied

satisfied

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* 8. The cleanliness of the pantry/soup itchen

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* 9. The services offered at this pantry/soup kitchen

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* 10. The friendliness / helpfulness of the staff and volunteers

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* 11. Are the foods received satisfactory

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* 12. How important is the pantry / soup kitchen to you

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* 13. Are there any issues / concerns you have seen at your local pantry?

Yes

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* 14. If YES, please explain:

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* 15. What services do you access at your local pantry?

Food Pantry

Baby Pantry

Senior Pantry

Pet Pantry

Clothing Bank

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* 16. Did you know that Anne Arundel County has a Food Bank?

Yes

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* 17. Did you know the Anne Arundel County Food bank is not the same as the Maryland Food Bank?

Yes

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* 18. Do you currently receive food assistance from any of the following programs? (circle all that apply)

Food Stamps

Medical Assistance

Energy Assistance

Unemployment Assistance

TANF

Soup Kitchens WIC (Woman, Infant and Children)

Food Pantries

School Meal Programs (Free and Reduced Lunch Program)

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* 19. If yes, how many times a month?

Once a month

Twice a month

Three times a month

Four times a month

Five times a month

Six times a month

Seven times a month

Eight or more times a month

It varies

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* 20. What best describes why you need help with food? (circle all that apply)

Ongoing need for food/insufficient income

Temporary health problem

Temporary job loss

Permanently Disabled

Experienced Disaster

Unexpected Household Expense

Have to pay other bills

Other

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* 21. The food that I obtain (purchased or received) doesn’t last through the month: (check all that apply)

Almost every month

Some months, but not every month

Only 1 or 2 months

Never

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* 22. Are there certain times of the month/year when this happens most often? If so, when? (Please check all that apply)

During the holidays

During the summer

At the end of the month

Every month

During the colder winter months

During the middle of the month

When the kids are home from school on break

At the beginning of the month

At the end of the year

All the time

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* 23. My household has the resources to eat balanced meals (meals that include meat, fruits, and veggies, grains and milk products): (check all that apply)

Almost every day

Some days, but not every day

Only 1 or 2 days a week

Never

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* 24. My household reduces the size of meals or skips meals. (circle all that apply)

Almost every day

Some days, but not every day

Only 1 or 2 days a week

Never

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* 25. Which of the following prevent you from obtaining fruit/vegetables on a regular basis? (Check all that apply)

Fruits and vegetables and other nutritious foods are too expensive in stores where I shop.

The fruits and vegetables are not available at pantries, in an inadequate supply.

There are few stores in my neighborhood which sell fruits/vegetables.

I do not have transportation to stores with quality fruit/vegetables.

I do not have transportation to stores with affordable fruit/vegetables.

The stores do not carry fruit/vegetables we eat in my culture.

Other. (explain) _____________________________________________________________

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* 26. Which of the following prevent you from eating fruits/vegetables in a regular basis? (Check all that apply)

I do not have enough time to prepare meals at home.

My family doesn’t like vegetables.

My family doesn’t like fruits.

I don’t know how to cook vegetables.

I’m not sure what choices are healthy or unhealthy.

Other. (explain) ______________________________________________________________

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* 27. Are you interested in recipe cards for how to make meals with fresh produce?

Yes

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* 28. How did you hear about this food pantry and/or soup kitchen? (check all that apply)

Friends

Family

Senior Center

Anne Arundel County Food Bank website

Calling the Anne Arundel County Food Bank

Flyers

Case worker

211

DSS

Word of mouth

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* 29. In addition to money, what are your barriers to obtaining food from this resource? (Check all that apply)

Availability / hours

Transportation to and from resource

Other. (explain) ________________________________________________________________

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* 30. How can this food pantry and/or soup kitchen better serve you?

Question Title

* 31. Thank you for participating in this survey.

Optional
Enter for a chance to win:

$100 gift certificate (one chance)
$50 gift certificate (two chances)

Name

Phone number (if available)

Email address (if available)

Other contact information

Client Survey

AAC Food Bank Client Survey

Question Title

* 1. How many people are in your household?

Question Title

* 2. How many children are in your household?

Question Title

* 3. Does anyone in your household have allergies?

Question Title

* 4. if Yes, please explain?

Question Title

* 5. How many pantries/soup kitchens have you had to go to in a month?

Question Title

* 6. Are the food quantities enough?

Question Title

* 7. Your overall visit experience

Question Title

* 8. The cleanliness of the pantry/soup itchen

Question Title

* 9. The services offered at this pantry/soup kitchen

Question Title

* 10. The friendliness / helpfulness of the staff and volunteers

Question Title

* 11. Are the foods received satisfactory

Question Title

* 12. How important is the pantry / soup kitchen to you

Question Title

* 13. Are there any issues / concerns you have seen at your local pantry?

Question Title

* 14. If YES, please explain:

Question Title

* 15. What services do you access at your local pantry?

Question Title

* 16. Did you know that Anne Arundel County has a Food Bank?

Question Title

* 17. Did you know the Anne Arundel County Food bank is not the same as the Maryland Food Bank?

Question Title

* 18. Do you currently receive food assistance from any of the following programs? (circle all that apply)

Question Title

* 19. If yes, how many times a month?

Question Title

* 20. What best describes why you need help with food? (circle all that apply)

Question Title

* 21. The food that I obtain (purchased or received) doesn’t last through the month: (check all that apply)

Question Title

* 22. Are there certain times of the month/year when this happens most often? If so, when? (Please check all that apply)

Question Title

* 23. My household has the resources to eat balanced meals (meals that include meat, fruits, and veggies, grains and milk products): (check all that apply)

Question Title

* 24. My household reduces the size of meals or skips meals. (circle all that apply)

Question Title

* 25. Which of the following prevent you from obtaining fruit/vegetables on a regular basis? (Check all that apply)

Question Title

* 26. Which of the following prevent you from eating fruits/vegetables in a regular basis? (Check all that apply)

Question Title

* 27. Are you interested in recipe cards for how to make meals with fresh produce?

Question Title

* 28. How did you hear about this food pantry and/or soup kitchen? (check all that apply)

Question Title

* 29. In addition to money, what are your barriers to obtaining food from this resource? (Check all that apply)

Question Title

* 30. How can this food pantry and/or soup kitchen better serve you?

Question Title

* 31. Thank you for participating in this survey.Optional Enter for a chance to win:$100 gift certificate (one chance)$50 gift certificate (two chances)

* 31. Thank you for participating in this survey.

Optional
Enter for a chance to win:

$100 gift certificate (one chance)
$50 gift certificate (two chances)