2010 Health Summit Survey
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1. MFH Health Summit Survey
1
. In what City and Zip Code do you reside:
In what City and Zip Code do you reside:
City/Town:
ZIP:
2
. What type of organization do you represent:
What type of organization do you represent:
Business
Community member
Elected official
Faith community
Government
Nonprofit
University
Other
3
. What issues are you most interested in hearing about at the 2010 MFH Health Summit? Check all that apply.
What issues are you most interested in hearing about at the 2010 MFH Health Summit? Check all that apply.
Chronic diseases
Federal health reform
Health literacy
Health professional workforce
Healthy and active living
Mental health and substance abuse
Missouri’s budget and economy
Patient-centered medical homes
Tobacco prevention/cessation
Women’s health
Other (please specify)
4
. What other issues would you be interested in hearing about?
What other issues would you be interested in hearing about?
5
. Who would you like to hear speak on any of the topics from the last two questions?
Who would you like to hear speak on any of the topics from the last two questions?
6
. What other factors would influence your decision to attend the 2010 MFH Health Summit?
What other factors would influence your decision to attend the 2010 MFH Health Summit?
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