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4. Please indicate how much you agree with the following statements about our Food and Clothing <br />program: <br /> <br /> Strongly <br />Agree <br />Agree Disagree Strongly <br />Disagree <br />N/A (not <br />applicable) <br />I feel welcomed in the Basic Needs <br />I feel comfortable asking questions about <br />the Basic Needs services <br /> <br />I feel my feedback about services is <br />valued <br /> <br />I feel respected in Basic Needs <br />I worry that people will see me accessing <br />services at Davis Street <br /> <br />The hours that Basic Needs offers <br />services (when the warehouse is open) <br />work for me <br /> <br />The referrals that Basic Needs provides <br />meet my needs <br /> <br /> <br /> <br />SUPPORT SERVICES <br />5. Please rate your level of satisfaction with the service(s) you have accessed in the last 12 months. <br /> <br /> Very <br />Satisfied <br />Satisfied Dissatisfied Extremely <br />Dissatisfied <br />Did not <br />use this <br />service <br />Did not <br />know <br />about this <br />service <br />Customer Service in the <br />Warehouse <br /> <br />Connecting clients with <br />other Davis Street programs <br /> <br />Special Programs (Back-2- <br />School program, Holiday <br />Basket program) <br /> <br />The following questions are in regards to the Food Warehouse: <br />Food Quality <br />Food Variety <br />Food Quantity <br />Food Frequency <br /> <br />Please tell us about your overall experience using these services: <br />____________________________________________________________________________________________ <br />____________________________________________________________________________________________ <br />____________________________________________________________________________________________ <br />DEMOGRAPHIC/HOUSEHOLD INFO