Limestone Medical Center Community Health Needs Assessment

Thank you for assisting us with this important survey!

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* 1. Considering the COMMUNITY /ENVIRONMENTAL HEALTH in your community, concerns are (choose up to THREE):

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* 2. Considering the AVAILABILITY/DELIVERY OF HEALTH SERVICES in your community, concerns are (choose up to THREE):

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* 3. Considering the YOUTH POPULATION in your community, concerns are (choose up to THREE):

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* 4. Considering the ADULT POPULATION in your community, concerns are (choose up to THREE):

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* 5. Considering the SENIOR POPULATION in your community, concerns are (choose up to THREE):

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* 6. Regarding various forms of VIOLENCE in your community, concerns are (choose up to THREE):

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* 7. What single issue do you feel is the biggest challenge facing your community?

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* 8. Considering PRIMARY HEALTHCARE, where do you primarily receive your Healthcare: (choose one)

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* 9. What PREVENTS community residents from receiving healthcare? (Choose ALL that apply)

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* 10. Where do you turn for trusted health information? (Choose ALL that apply)

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* 11. Where do you find out about LOCAL HEALTH SERVICES available in your area? (Choose ALL that apply)

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* 12. What specific healthcare services, if any, do you think should be added locally?

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* 13. Do you believe individuals in the community would financially support any of the following capital improvements by Limestone Medical Center? (Choose ALL that apply)

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* 14. Age:

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* 15. Highest level of education:

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* 16. Gender:

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* 17. Employment status:

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* 18. Your zip code:

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* 19. Race/Ethnicity (choose ALL that apply):

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* 20. Income

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* 21. Overall, please share concerns and suggestions to improve the delivery of local healthcare.

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