1.1 What is your Gender Identity?^*

1.2 In Question (1.1) If you selected 'Female', are you currently Pregnant?

1.3 How Old are you?^*

1.4 What is your Highest Level of Education?^*

1.5 In which Region do you Stay?^*

2.1 Would you like to be Identified as a Key Population?^*

2.2 In Question (2.1) If you answered 'Yes', Please select all that apply?

3.1 Which of the following Services are you here for today? Select all that apply.^*

3.2 Whenever you come to the Health Facility, are there always enough Staff to meet the needs of the Patients?^*

3.3 In Question (3.2) If you answered 'No', which of the following Health Staff are not enough? Select all that apply.

3.4 How long did you have to Wait to be Assisted today?^*

3.5 In the last three (3) months, did you ever Leave this Health Facility without getting the Services you came for?^*

3.6 In Question (3.5), if you answered 'Yes', how many times has this happened to you?

3.7 In Question (3.5), if you answered 'Yes', Why did you leave the Health Facility without getting the Service you came for? Select all that apply.

3.8 In Question (3.7), If you answered 'Short supply of medication'. Which of the following medication was in short supply? Select all that apply.

3.9 Do you feel that this Health Facility respects the people's Confidentiality and Privacy?^*

3.10 Did you ever Experience any form of Discrimination from Staff at this Facility?^*

3.11 How Satisfied are you with the Services provided at this Facility?^*