Screening questions

Attachment 10 Screening questions.docx

Generic Clearance for Questionnaire Pretesting Research

Screening questions

OMB: 0607-0725

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SNAP Client Integrity Message Cognitive Testing Screening Questions


  1. Do you currently receive food assistance benefits from the State of FILL STATE? These are sometimes called food stamps or SNAP. The benefits are often deposited onto an EBT card.

Yes

No

Don’t know/Not sure



  1. [IF Q11=NO] Have you ever received food assistance benefits from the State of FILL STATE?

Yes

No

Don’t know/Not sure



  1. [IF Q11=NO AND Q12=NO] Have you ever received food assistance from a local service, such as a food bank or a food pantry?

Yes

No

Don’t know/Not sure





File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleSlight changes to participate
AuthorDawn V Nelson
File Modified0000-00-00
File Created2023-08-31

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