Individuals and Households

COMMUNITY PARTNER INTERVIEW DEMONSTRATION PROJECT CLIENT SATISFACTION SURVEY

Instructions: The United States Department of Agriculture (USDA) administers the Supplemental Nutrition Assistance Program (SNAP). The USDA is cooperating with [insert State SNAP name and community organization name].  The USDA would like to learn more about your experience applying for benefits at [insert community organization name]. The survey includes questions about your experience applying for benefits. Participation to this survey is voluntary and will not impact your eligibility for the program if you decide not to respond either as a whole or to any particular questions.  Your answers will help us improve our service. Your answers will be kept private and not be disclosed in identifiable form to anyone; except as otherwise required by law.

1. Did you choose this location because:

   1. You didn’t know there was another way to apply

   2. You go there for other services

   3. You feel comfortable going there

   4. It is conveniently located

   5. It has convenient hours of operation

   6. You don’t have to wait a long time there

   7. The people who work there are friendly

   8. The people who work there speak your language

   9. The people who work there speak your language

   10. Someone referred you there

2. How long did you have to wait? Was it:

   1. Less than 15 minutes

   2. Between 15 and 30 minutes

   3. More than 30 minutes but less than an hour

   4. More than an hour

   5. Don’t know

3. Thinking about your most recent experience applying for [Insert State SNAP program name], how did it compare to your previous experience? Was it easier to apply this time, harder or about the same?

   1. Easier to apply this time

   2. Harder to apply this time

   3. About the same

   4. Don’t know

4. Did you feel like this location offered you enough privacy?

   1. Yes

   2. No

   3. Don’t know

5. Overall, the staff I met was very knowledgeable about the [Insert State SNAP program name] and the procedures for applying for benefits. Do you:

   1. Strongly agree

   2. Agree

   3. Disagree

   4. Strongly disagree

   5. Don’t know

6. Thinking again about your interview for[Insert State SNAP program name], how satisfied were you with the overall interview process, such as scheduling the interview if you had to do that, and having the interviewer explain the verification procedures in a way that was clear to you? Were you:

   1. Very Satisfied

   2. Satisfied

   3. Dissatisfied

   4. Very Dissatisfied

   5. Don’t know