On behalf of the Allegany County Department of Health, Cuba Memorial Hospital, Jones Memorial Hospital and the Community Wellness Committee of Allegany County; thank you for participating in the 2019 Community Health Assessment Survey.

The following survey is only for adults 18 years of age and older. It is an opportunity for you to voice your opinion about our community’s health and wellness. As well, health care leaders will gain knowledge about our current health care system, learn important information about our community’s health status, and find new ways to support our community in becoming the healthiest county in New York State. We encourage all Allegany County residents to participate.

To thank you for your participation you will be entered into a drawing for a chance to win one of six (6) $50 gas gift certificates or one of eight (8) $25 gas gift certificates.  Upon completion of the survey, you will be directed to a separate page to add your contact information for a chance to win one of these prizes.

We appreciate your help.  Surveys must be completed and received via the on-line survey or by mail to no later than Friday, April 26th, 2019: Please mail your survey to: Attention: Theresa Moore, Allegany County Department of Health, County Office Building, 7 Court Street, Belmont NY 14813.

Question Title

* 1. Do you have any kind of health care coverage or health insurance? 

Question Title

* 2. How do you pay for your Health Care? (Check all that apply) 

Question Title

* 3. Where do you get most of your health information? (select up to three (3) choices)

Question Title

* 4. How often do you see your primary care provider (doctor)?

Question Title

* 5. In the past year, was there any time that you needed medical care but could not - or did not - get it?

Question Title

* 6. What were the main reasons you did not get the medical care you needed?  (Please choose all that apply:)

Question Title

* 7. In the past year, was there any time that you needed mental health care but could not-or did not- get it?

Question Title

* 8. In the past year, was there any time that you or your children needed dental care but could not-or did not- get it?

T