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1. "Tell us what you think..."

North Country Hospital (NCH) wants to hear from everyone living in Orleans & Northern Essex counties!
Please take this survey and tell us what you think the needs/issues are impacting the health of our community.
All answers are confidential. No names please!

Question Title

* Please tell us what you think:
1. Tell us if you feel resources are available to people that need them AND
2. Tell us if you feel this need/issue is important
Children/Families

  Resources Importance
Services for people who are pregnant
Services for new parent(s) & babies
Affordable childcare
Resources for weight management
Resources to prevent/treat tobacco use
Resources to prevent/treat vaping
Resources to prevent/treat alcohol use
Resources to prevent/treat the use of street drugs
Resources for mental health care for children
Resources for mental health care for teens
Resources to prevent suicide among children or teens
Resources for dental needs among children
Resources for 2- or 3-bedroom affordable housing

Question Title

* Please tell us what you think:
1. Tell us if you feel resources are available to people that need them AND
2. Tell us if you feel this need/issue is important
Adult health

  Resources Importance
Resources for weight management
Tobacco use resources
Vaping use resources
Dental needs
Vision needs
Affordable prescription drugs
Cancer: screening/testing
Cancer treatment
Chronic diseases (diabetes, heart conditions, etc.)

Question Title

* Please tell us what you think:
1. Tell us if you feel resources are available to people that need them AND
2. Tell us if you feel this need/issue is important
Mental health & substance use among adults

  Resources Importance
Resources for alcohol misuse
Resources for misuse of prescription drugs
Resources for use of street drugs/opioids
Resources for mental health care
Resources to prevent suicide

Question Title

* Please tell us what you think:
1. Tell us if you feel resources are available to people that need them AND
2. Tell us if you feel this need/issue is important
Older Vermonters

  Resources Importance
Resources for housing
Resources for meal programs
Resources for home health care
Resources for Nursing Home/other 24-hour care
Resources for elder abuse

Question Title

* Please tell us what you think:
1. Tell us if you feel resources are available to people that need them AND
2. Tell us if you feel this need/issue is important
Community members-Any age

  Resources Importance
Affordable & healthy food
Affordable exercise or fitness programs
Recreation activities, such as hiking, swimming
Safe walking and/or bike paths & sidewalks
Access to affordable housing
Access to affordable education after high school
Good paying jobs
Primary Care when needed without going to the emergency room
Urgent care/walk-in care when needed without going to the emergency room
Support services for people who need end-of-life (Hospice)
Resources for personal safety/domestic violence
Resources for legal concerns

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* Please use this space to tell us about other needs that impact the health of our community and if there are challenges with resources to meet them:

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* If you or someone close to you were not able to receive any of the services/resources above, please check all reasons that apply.

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* What town do you live in?

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* Age:

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* What do you consider yourself to be?

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* Are you a veteran?

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* How would you describe your race or ethnicity?

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* In what language do you prefer to receive services?

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* Are you caring for an elderly person who needs 24-hour service/care?

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* Are you caring for a child/children under the age of 6?

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* Which best describes you current work status?

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* Highest level of education:

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* My household income is:

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* Please indicate what insurance coverage you and your family have:
Check all that apply

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* How concerned are you about climate change?

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