Community Health Wave 3 Survey Screenshots

Attachment 4c: Representative Screenshots of Online Screener and Survey for
Wave 3: Food
Screenshot – Online Screener Home Page

1

Screenshot – Online Screener Question S1

2

Screenshot – Online Screener Question S2

3

Screenshot – Online Screener Question S3

4

Screenshot – Online Screener Question S4

5

Screenshot – Online Screener Question S5

6

Screenshot – Online Screener Question S6

7

Screenshot – Online Survey Home Page

8

Screenshot – Online Survey Question Q1

9

Screenshot – Online Survey Question Q 1_1

10

Screenshot – Online Survey Question Q 1_2

11

Screenshot – Online Survey Question Q 1_3

12

Screenshot – Online Survey Question Q 2

13

Screenshot – Online Survey Question Q 11

14

Screenshot – Online Survey Ad Viewing Screen

15

Screenshot – Online Survey Transition Screen

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Screenshot – Online Survey Question Q12

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Screenshot – Online Survey Question Q13

18

Screenshot – Online Survey Question Q14

19

Screenshot – Online Survey Question Q15

20

Screenshot – Online Survey Question Q16: Wave 3

21

Screenshot – Online Survey Completion Screen

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