1. Have you ever utilized services and/or programs from the Jessamine County Health Department (JCHD)?

2. Please check all preventative (medical) services that you have used. (check all that apply)

3. Please select the following that pertain to you. (check all that apply)

4. Have your children been involved in any of the health programs/services at school? (check all that apply)

5. Are you aware or have you participated in the HANDS program (Health Access Nurturing Development Services) for first time parents?

6. Have you participated in any of the following worksite/offsite wellness programs in which the Jessamine County Health Department was involved? (check all that apply)

7. Where do you go for health information? (Choose all that apply)