The Allegany County Health Department is proud to announce the upcoming launch of our new H.E.A.L.Mobile mobile wellness clinic van, which will bring a variety of health department services to local communities throughout Allegany County! As we prepare to begin offering mobile services, we want your input on potential locations for the van to park and which of the proposed services are most important to you. Thank you for taking the time to complete this brief survey. Your opinion matters!

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* 1. What is your zip code?

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* 2. Please rank the following services in order of their importance to you (most important at the top to least important at the bottom):

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* 3. Are there other public health services not currently listed which you would like to suggest for consideration as a mobile clinic?

Considering the large size of the H.E.A.L.Mobile (about the size of a large camper or RV), what suggestions do you have for locations in your community where the vehicle could easily pull in and out (ideally without having to back up or turn around)? Please provide as much information as possible (site name, address if known, contact person, phone number, etc.).

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* 4. Site Suggestion #1

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* 5. Are any of these items available at site #1? Please check all that apply.

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* 6. Site Suggestion #2

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* 7. Are any of these items available at site #2? Please check all that apply.

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* 8. Site Suggestion #3

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* 9. Are any of these items available at site #3? Please check all that apply.

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* 10. Are there specific local events that you would like to see the H.E.A.L.Mobile attend?

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* 11. Additional comments or suggestions?

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