APLA Health Donor Survey
Please take 5 minutes to help APLA Health get to know you and your needs.
Your response by July 1, 2017, would be greatly appreciated.
How did you become a donor to APLA Health?
Which of the following best describes your motivation for donating to charity? Please choose no more than two:
What are some of the guiding principles you use to make your philanthropic decisions? Please rank the following by importance, 1 being most important:
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2
3
4
5
6
The charity has personal relevance to me
The charity is transparent
The charity is making an impact in the community
The charity is fiscally sound and responsible
A high percentage of donor funds are spent on direct services
The charity has effective leadership
How familiar are you with APLA Health?
Were you aware that APLA Health now provides a full spectrum of health care services as a Federally Qualified Health Center (FQHC), in addition to providing HIV/AIDS support services?
As a donor, which Health Care Services provided by APLA Health are the most important to you? Please rank the following by importance, 1 being most important:
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2
3
4
5
PEP & PrEP / HIV Testing / STD Screening and Treatment
Primary Medical Care / Vaccinations
Behavioral Health / Counseling
Dental Care
Insurance Enrollment
As a donor, which HIV Support Services provided by APLA Health are the most important to you? Please rank the following by importance, 1 being most important:
1
2
3
4
5
HIV Prevention / HIV Education
Care Coordination Services / Clientline
NOLP Food Pantries & Nutrition
HIV Medical Care / Home Health Care
Benefits Counseling / Housing Support Services
Are you optimistic about the future of APLA Health?
Would you mind telling us why?
Your answer
What types of charities do you personally support financially?
Support
Occasionally Support
Do Not Support
Animal Welfare
Art, Culture & Humanities
Children, Youth & Families
Education
Emergency Preparedness & Response
Environment
Health Care
Human & Civil Rights
LGBTQ and/or HIV/AIDS
Political
Poverty & Homelessness
Religious
STEM (Science, Technology, Engineering & Math)
Has APLA Health been an efficient steward of your donations and resources?
Would you mind telling us why?
Your answer
Do you feel APLA Health effectively communicates its need for donations?
How satisfied are you with the information you receive regarding the way your donation is used?
Would you mind telling us why?
Your answer
Are you thanked in a timely manner for your gifts?
How satisfied are you with the relationship between APLA Health and yourself as a donor?
Are you reading APLA Health’s "Optimist" quarterly email newsletter?
Are you reading APLA Health’s "In The Loop" biweekly email newsletter?
Have you read our most recent annual report, which is posted on our website?
How likely is it that you would include APLA Health in your estate planning / legacy giving?
Do you have any additional comments, questions or concerns you would like to share with APLA Health?
Your answer
Optional Questions – For Statistical Purposes Only
Sexual orientation:
Gender identity:
Age:
Your ZIP Code:
Your answer
Ethnicity:
Marital status:
Highest education level completed:
Annual household income:
Occupation:
Your answer
If you do not wish to remain anonymous, please provide your name and address here:
Name:
Your answer
Physical address:
Your answer
Email address:
Your answer
Would you like more information on how your donations are being used?
Thank you for completing our questionnaire!
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