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* 1. When did you last receive a product or service (e.g. loan or counseling session) from Justine PETERSEN?

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* 2. When did you first start working with Justine PETERSEN?

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* 3. If you interacted with Justine PETERSEN staff, how flexible would you say staff were?

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* 4. If you interacted with Justine PETERSEN staff, how respectful would you say staff were?

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* 5. Please describe your experience with the JP staff person ( or persons) who you interacted with.

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* 6. Which Justine PETERSEN products or services have you used? Please check all that apply.

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* 7. If you received more than one service from JP. which service felt most useful to you and why?

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* 8. Are there any positive changes/improvement after you received services from JP?

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* 9. How likely is it that you would recommend this company to a friend or colleague?

NOT AT ALL LIKELY
EXTREMELY LIKELY

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* 10. Has your quality of life changed because of Justine PETERSEN's products or services?

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* 11. Have you experienced any challenges with accessing or using Justine PETERSEN's products or services? If so, what were they?

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* 12. Is there anything Justine PETERSEN could offer that would better meet your needs?

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* 13. Do you have access to a computer with audio/video capabilities?

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* 14. Would you be interested in and comfortable with video services through a platform such as Zoom or FaceTime given the option?

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* 15. What is your age?

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* 16. Please identify your race.

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* 17. Please identify your ethnicity.

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* 18. Please identify your gender.

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* 19. What is your zip code?

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* 20. Please estimate your annual income:

T