Community Food Aid Survey Form
Share your community’s food needs and experiences accessing food aid.
How many people live in your household?
*
How often is there not enough food for your household?
*
Never
Rarely
Sometimes
Often
Very often
Have you or someone in your household used food aid in the past 12 months?
*
Yes
No
Not sure
How familiar are you with food aid services available in your community?
*
Not familiar
1
2
3
4
Very familiar
5
1 is Not familiar, 5 is Very familiar
What makes it difficult for people in your community to access food aid?
*
Not knowing where to go
Transportation or distance
Hours or scheduling
Limited availability of food
Language or communication barriers
Other
Which food aid formats would be most useful?
*
Ready-to-eat meals
Groceries to prepare at home
Fresh produce
Meal kits
Food delivery
Other
Which food categories are most needed in your community?
*
Fresh fruits and vegetables
Grains and bread
Protein foods
Dairy or alternatives
Shelf-stable pantry items
Other
Which days would be most convenient for food aid distribution?
*
Monday–Friday
Saturday
Sunday
Any day
How long does it usually take to reach a food aid location?
*
Please Select
Under 15 minutes
15–30 minutes
31–60 minutes
More than 60 minutes
Not applicable or unsure
What other food-related needs or improvements would you like to see addressed in your community?
Submit Survey
Should be Empty: