Rate Shopping Experience

WIC Nutrition Program/CSFP

Dear Participant,

New Mexico grocery stores play a vital role in our program. As a retail grocery store or pharmacy, the grocer supplies specific authorized foods that were prescribed to you, or your child, on the food package by the WIC Nutritionist. It is the responsibility of the grocer to ensure that you have access to all the prescribed foods. The grocers’ ability to provide access to the foods on your prescription, promote a healthy pregnancy and birth, as well as healthy developmental stages for you and/or your child.

Please take a few moments to answer the following questions and let us know how our authorized Grocers are doing.

Your e-mail address:

Which store did you receive services from:

Store name:
Store address:
City:

Please mark the circle that represents how you react to each of the following comments:

During the store transaction did you receive
a verbal greeting? 		Fair Good Great
Were store associates pleasant during the transaction? Fair Good Great
Were the store associates responsive to your needs? Fair Good Great
Were store aisles clean and free from obstruction? Fair Good Great
Was a store associate available for assistance? Yes No N/A
Were you satisfied with the store services provided? Fair Good Great
Would you visit this grocery store again? Yes No

Were you able to purchase the WIC foods listed
on your benefits?
Yes No

Please indicate the food item(s) that you were unable to purchase.
Be as specific as possible:

What recommendation do you have to better serve you?
List any complaints and/or concerns that need to be addressed.


Please enter the confirmation code seen above:


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