Thank you for completing this online survey regarding Health Care issues in Connecticut. You can enroll in a drawing to win one of five $50 VISA gift cards if you complete this survey. In order to participate, you must complete the online survey and include your contact information - first and last name, mailing address, phone number (and email if possible), and your name will be entered into the drawing. This drawing is completely optional and is offered by the Connecticut Department of Public Health through the MCHBG Needs Assessment Grant to thank you for your participation. The drawing is open to all Connecticut residents. Employees of the state of Connecticut, independent contractors and officers and directors of the state and its affiliates, subsidiaries, advertising, promotion and fulfillment agencies and legal advisors and the immediate family members and persons living in the same household of such persons, are not eligible to participate in the drawing; void where prohibited by law. Surveys must be completed and submitted online by January 31, 2010. Winners of the drawing will be randomly selected and will be contacted by March 1, 2010.

Each year, states like Connecticut apply to the federal Maternal and Child Health Bureau (MCHB) for Block Grant funds.These funds are also called "Title V (five)" because they are authorized by Title V of the Social Security Act.

The Connecticut Department of Public Health then gives funds to local health programs that serve families. This funding is to help improve the health of families and make sure all families in Connecticut can get what they need to be healthy.

We need your help to make sure this funding helps families like yours get the health care they need.

This short survey will ask you about your family's HISTORY DURING THE PAST YEAR and their ability to get good health care. It will also ask what you think the State's health priorities should be. It should only take 10-15 minutes to complete.

Thank you for helping us meet the health needs of Connecticut families.