Zero Pinellas
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Zero Pinellas Participant Satisfaction Survey (revised 3-1-19)

1. How did you learn of Zero Pinellas?
*Required
Select all that apply.
Website
During Testing
Newsletter
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Facebook
Twitter
Instagram
Friend
Outreach Event
Other    (Please specify)  

OVERALL Satisfaction


2. OVERALL SATISFACTION
*Required
 strongly disagreedisagreeagreestrongly agree
1. I had a good overall experience with Zero Pinellas.
2. I found the types of information and assistance I needed at Zero Pinellas.
3. Because of my experiences with Zero Pinellas, I am better able to find the services I need.
4. I feel that Zero Pinellas has helped me to take better care of myself.
5. I would recommend Zero Pinellas to a family member or friend.

HIV Testing


3. Did you receive Zero Pinellas HIV Testing Services?
*Required
Yes
No

4. HIV Testing
 strongly disagreedisagreeagreestrongly agree
1. I was given the chance to ask questions about the HIV test before agreeing to be tested.
2. I was given the chance to say “NO” to testing, but was encouraged to consider taking it.
3. I understood the information I was given about the HIV Test.
4. My test and discussion of the results were done in private and I felt that my privacy was respected.

PrEP Services


5. Did you receive Zero Pinellas PrEP Services?
*Required
Yes
No

6. PrEP Services
 strongly disagreedisagreeagreestrongly agree
1. The PrEP navigator was available to answer questions I had about PrEP.
2. The PrEP navigator was available to answer questions I had about HIV prevention/risk reduction activities.
3. I was treated with courtesy and respect by the PrEP navigator who helped me.
4. I received information about PrEP in a timely and efficient manner.

ICM Services


7. Did you receive Zero Pinellas case management services?
*Required
Yes
No

8. Intensive Case Management Services
 strongly disagreedisagreeagreestrongly agree
1. When I needed an appointment with my case manager, I could see my case manager soon enough for my needs.
2. My case manager helped me get the services I needed most.
3. My case manager was good at showing me how I could help myself to better meet my own individual needs.
4. My case manager and my medical providers worked well together to help me with my medical care needs.

Other Comments


9. Please use this space to write anything else you would like to say about your experiences as a participant in Zero Pinellas.