This survey is to be completed by the HEAL coordinator together with the store owner or representative at the onset and conclusion of the program to tailor technical assistance and track changes in capabilities.
On a scale of 1 to 5 (1=Strongly Disagree, 2=Disagree, 3=Neither agree nor disagree, 4=Agree, 5=Strongly Agree) please indicate the store owner’s level of agreement with the following statements:

Question Title

* 1. You feel capable of procuring/purchasing fresh, frozen, and canned produce.

  1
Strongly Disagree 		2
Disagree 		3
Neither agree nor disagree 		4
Agree 		5
Strongly Agree
Fresh Produce
Frozen Produce
Canned Produce

Question Title

* 2. You feel capable of promoting and marketing fresh, frozen, and canned produce.

  1
Strongly Disagree 		2
Disagree 		3
Neither agree nor disagree 		4
Agree 		5
Strongly Agree
Fresh Produce
Frozen Produce
Canned Produce

Question Title

* 3. You feel capable of storing and handling fresh, frozen, and canned produce.

  1
Strongly Disagree 		2
Disagree 		3
Neither agree nor disagree 		4
Agree 		5
Strongly Agree
Fresh Produce
Frozen Produce
Canned Produce

Question Title

* 4. You feel capable of displaying fresh, frozen, and canned produce for optimal sales.

  1
Strongly Disagree 		2
Disagree 		3
Neither agree nor disagree 		4
Agree 		5
Strongly Agree
Fresh Produce
Frozen Produce
Canned Produce

Question Title

* 5. You feel capable of tracking your store’s fresh, frozen, and canned produce inventory and sales.

  1
Strongly Disagree 		2
Disagree 		3
Neither agree nor disagree 		4
Agree 		5
Strongly Agree
Fresh Produce
Frozen Produce
Canned Produce

Question Title

* 6. You feel capable of optimally pricing fresh, frozen, and canned produce.

  1
Strongly Disagree 		2
Disagree 		3
Neither agree nor disagree 		4
Agree 		5
Strongly Agree
Fresh Produce
Frozen Produce
Canned Produce

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* 7. You have a good relationship with your customers.

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* 8. You have a strong understanding of what your customers want.

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* 9. You are interested in connecting with local farmers or distributors to offer SC grown produce.

Question Title

* 10. You have sufficient space/shelving to increase your offerings of:

  No Space Some Space Plenty of Space
Fresh Produce
Frozen Produce
Canned Produce

Question Title

* 11. Name

Question Title

* 12. Date of survey completion by retail owner or representative

Date

Question Title

* 13. Any additional comments or clarification

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