Additional screener questions

additional screener question enclosure 7_OMB_elo.docx

Generic Clearance for Internet Panel Pretesting and Qualitative Survey Methods Testing

Additional screener questions

OMB: 0607-0978

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Additional screener questions (Approved in original OMB letter)

  • Question: Do you currently receive Supplemental Nutrition Assistance Program SNAP benefits (or Food Stamps)?

    • Yes

    • No


  • Question: Have you ever applied for Supplemental Nutrition Assistance Program (SNAP) (also known as Food Stamps)?

    • Yes

    • No

      • IF yes: Did you apply online or in person/on paper?

        • Online

        • In person / Paper

  • Question: Are you currently thinking about applying for SNAP/Food Stamps?

    • Yes

    • No

  • Question: Have you applied for other social services from your state?

    • If so – can you tell me what you applied for?________________________

    • How long ago?______________________

    • Did you apply online or in person/on paper



New question for this addendum:

  • Question: If you qualified for food stamps, would you apply?

    • Yes

    • No

      • IF yes: Would you apply online or in person/on paper?

        • Online

        • In person / Paper



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorErica L Olmsted Hawala (CENSUS/CSM FED)
File Modified0000-00-00
File Created2022-03-24

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