Coconino County Community Health Needs Assessment Survey

Coconino County Health and Human Services is conducting the following survey to get your opinion about community health and needs in Coconino County. The results of this survey, along with other collected information, will be used to identify the most pressing concerns and where we should focus our work through community action. Your feedback and opinions are greatly appreciated.

El Departamento de Salud y Servicios Humanos del Condado de Coconino está llevando a cabo la siguiente encuesta para conocer su opinión sobre la salud y las necesidades de la comunidad en el Condado de Coconino. Agradecemos mucho sus comentarios y opiniones. Enlace a la encuesta en español aquí: https://www.surveymonkey.com/r/RFBYF2Z.

2.What is the highest level of school you have completed or the highest degree you have received?(Required.)

Less than high school diploma

High school diploma or equivalent (i.e., GED)

Some college but no degree

Technical/vocational degree or certificate

Associate's degree

Bachelor's degree

Master's degree

Doctorate or Professional degree (e.g., MD, DDS, PhD, EdD)

5.Are you of Hispanic, Latino, or of Spanish origin? (Select all that apply)(Required.)

6.Are you Native American or Alaska Native? If yes, please specify your Tribal affiliation in the box below.(Required.)

Yes

No

Tribal Affiliation

7.What is your race? Select all that apply.(Required.)

White/Caucasian

Black/African American

Native American or Alaska Native. Please specify your tribal affiliation in the question above.

Native Hawaiian or Other Pacific Islander

Middle Eastern or North African

Asian

Prefer not to answer

8.What is your sex?(Required.)

Male

Female

Prefer not to answer

10.Do you currently have children under the age of 18 living with you?(Required.)

Yes

No