Which service(s) do you receive from Open Hand? (Check all that apply)
Prepared Meals
Pantry Bags
Produce Boxes
Nutritional Supplements
Nutrition Counseling or counseling from a dietitian
How many meals do you receive weekly? Please write in the amount you receive (write 0 if you do not receive meals).
How many nutritional supplements do you receive each week? Please write in the amount you receive (write 0 if you do receive nutritional supplements).
What program or funding source are you enrolled in for meals?
Fee for service Fulton Senior HOPWA Ryan White Med Ace Care Management Med Faith Health Services Med Next Step Care Conyers Med Next Step Care Rome Med Next Step Care Tyrone Med Source Partners Med CCSP Med - On My Watch Med - A Step Above Pruitt Health Gwinnett Pruitt Health CCSP
How long have you received meal services from Open Hand?
One time delivery
Less than a year
1-2 years
3-4 years
5 years or more
Why have you continued meal services with Open Hand? (Please check all that apply)
I have no other options
I am satisfied with the food
I am satisfied with the delivery
Other (please describe)
If other, please describe why you have continued meal services with Open Hand
How do Open Hand meal services compare to meal services you have received from other agencies?
Better
Same
Worse
Does not apply to me (I have not received meal services from other agencies)
Open Hand & Your Health
During the past year, have you experienced changes in the number of emergency room visits compared to the previous year (2020)?
Fewer visits
About the same
More visits
Does not apply to me (I did not visit the ER in either 2021 or 2022)
During the past year, have you experienced changes in the number of days spent hospitalized compared to the previous year (2020)?
Fewer days
About the same
More days
Does not apply to me (I was not hospitalized in either 2021 or 2022)
During the past year, have you experienced changes in the ease of taking your medications?
Easier
About the same
Harder
Does not apply to me (I do not take medications)
If you have any health conditions or physical limitations, please list them here (i.e. Diabetes, Heart Disease, Other):
How much would you estimate you've saved at the grocery store each week because you are receiving meals, pantry bags, nutrition supplements, or other items, considering costs of food for your entire household?
$0
$1 - $25
$26 - $50
$51 - $75
$76 - $100
More than $100
Have you spoken to an Open Hand Dietitian about nutrition and your health?
Yes
No
How would you rate your overall experience with the Dietitian?
Very Helpful
Somewhat Helpful
Not Helpful
Why not? (Check all that apply)
I did not know about the service
I saw a Dietitian or Nutritionist somewhere else
I did not see a need
Other
If other, please describe:
How has speaking with a Open Hand dietitian changed your food & nutrition-related habits? (Check all that apply)
I choose healthier foods while grocery shopping
I have learned to prepare healthy meals on my own
I have learned how to read nutrition facts and ingredient labels
It has not changed my nutrition-related habits
Other
I have not spoken with a dietitian from Open Hand
If other, please describe:
Male
Female
Transgender (M to F)
Transgender (F to M)
Non-binary
Other
If other, please specify:
0-18 years
19-24 years
25-34 years
35-44 years
45-54 years
55-64 years
65+
With what racial group(s) do you identify? Please check all that apply.
African American or Black
White
American Indian or Native American
Asian
Native Hawaiian or Other Pacific Islander
Other
If other, please specify:
Are you Hispanic or Latino?
Yes
No
Yes
No
Would you be interested in receiving lactose-free milk options?
Yes
No
What are your favorite foods on the Open Hand meal menu?
What are your least favorite foods on the Open Hand meal menu?
What other healthy foods that Open Hand does not currently provide would you like for us to start providing?
Is there anything that would make Open Hand meals, delivery drivers, Dietitian Nutritionists, client services staff or nutrition handouts more helpful to you?
Please tell us the impact that our meal service has had on your life.
If you would like to offer a note of thanks, please include it here.
Thank you for your participation! Please press submit to record your response.
