Survey: Support Eligibility
Apply for support and access our nourishing products at a reduced cost.
Do you identify as any of the following demographics?
Please Select
BIPOC
Women
Underserved
LGBTQ
Are you currently facing financial barriers that limit your ability to purchase wellness products?
(Yes/No with short answer)
How would you describe your access to affordable, healthy beverages in your area?
Limited
Moderate
Abundant
Do you reside in a community that is historically underserved or experience limited access to health focused products?
Yes
No
Somewhat
What specific support would make the most difference for you in accessing our products?
Please leave your email address if you would like us to contact you regarding any questions.
Name:
E-mail Address
Thank you for completing our survey.
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