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UCATS - Shopping Survey
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First Name
*
Last Name
*
Phone Number
Please select your favorite grocery store out of the following four options
(Select One)
Kroger
Wal-Mart
Aldi/Dollar General
Meijer
Please select your LEAST favorite grocery store out of the following four options
(Select One)
Kroger
Wal-Mart
Aldi/Dollar General
Meijer
Is there a store or shopping location that you would like to visit on shopping days?
How much time does it typically take you to shop (To fill 2 grocery bags worth of items)?
(Select One)
<30 Minutes
30 - 45 Minutes
45 - 60 Minutes
60 - 90 Minutes
90 - 120 Minutes
120+ Minutes
Are there any challenges that you face when shopping with UCATS?
If UCATS has cancellations, would you be available for same-day trips to go shopping?
Yes
No
If YES, may we add your name and phone number to a list to contact in the future?
Yes
No
What day(s) of the week would be the best to go shopping (Select all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Do you prefer to shop in the morning, afternoon, or either?
(Select One)
Morning
Afternoon
Either
Is there any additional feedback you would like to share about shopping with UCATS?
Submit
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