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Survey title

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

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1

What are the most important needs you have?

Select the option that best represents your needs.
2

How would you rate the urgency of your needs?

Rate the urgency on a scale from 1 to 10.
3

Please describe in detail the needs you currently have.

Provide a detailed answer describing your needs.
4

Are there any specific challenges you are facing in meeting your needs?

Select yes or no.
5

What resources do you believe would be most helpful in addressing your needs?

Select the resources you think would be most helpful.
6

How satisfied are you with the support you are currently receiving?

Rate your satisfaction on a scale from 1 to 10.
7

In what ways do you think your needs could be better addressed?

Provide your thoughts and suggestions for improvement.
8

Do you feel understood and respected in your interactions with service providers?

Select yes or no.
9

What barriers do you face in getting your needs met?

Select the barriers you are facing.
10

Additional comments

Feel free to add any additional comments or information.
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