Steuben County Public Health & Nursing Services is asking for your assistance. Please fill out this survey to help us determine the best way to contact you in an emergency.

The information you provide will help us make a plan to reach as many people as possible, as fast as possible, during a public health emergency. THANK YOU!

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* 1. Which of the following do you use? (please check all that apply):

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* 2. What is your primary phone line?

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* 3. What type of television access do you have?

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* 4. How do you access the internet? (check all that apply)

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* 5. Which social networking sites do you use? (check all that apply)

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* 6. Please list your primary source for news and information under each:

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* 7. Where did you get most of your information regarding health related issues? (i.e. influenza)

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* 8. How would you prefer to receive information about health related issues?

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* 9. During a public health emergency Steuben County will be calling on volunteers to assist in the response. Would you be interested in being a volunteer? If so please CLICK HERE.

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* 10. During a public health emergency Steuben county will be calling on volunteers to assist in the response. Would you be interested in being a volunteer? If so please provide your name and contact information or CLICK HERE or copy this path into your browser https://apps.nyhealth.gov/vms/appmanager/vms/public?prog=49

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