HC Administrator Survey DEMOGRAPHIC INFORMATION Question Title * 1. What is the five-digit zip code of the main administrative site of your Health Center (HC)? OK Question Title * 2. If your HC has sites in any other state(s), please list the state(s) here: OK Question Title * 3. Which best describes the communities served by your HC? Please check all that apply. Suburban Urban Rural OK Question Title * 4. Which best describes your position? CEO/Executive Director Chief Dental Officer Vice President Dental Director Staff Dentist Dental Manager Other (please specify) OK Question Title * 5. Are you a dentist? Yes No OK Question Title * 6. Does your HC have any sites where medical and dental services are co-located? Yes No Please provide any relevant comments: OK Question Title * 7. Does your HC provide direct, on-site oral health care services to children (0-5) years? Yes No If you answered "no", please explain why not. OK NEXT