PART A: Community Perspective

Question Title

* 1. How would you describe the quality of health care in our community?

Question Title

* 2. In your words, how does the community feel about health care providers? (Be specific)

Question Title

* 3. During the last assessment, the issues below were identified as concerns for our community. Please mark concerns you still have? (Select all that apply)

Question Title

* 4. In our community, which issues are now the most important to you? (Select top three)

Question Title

* 5. How big of a problem are the following health care issues in our community?

  Not a problem Somewhat of a problem Very big problem Don't know
Access to primary health care
Alcohol/ illegal drug abuse
Arthritis, joint/back pain
Cancer
Diabetes
Heart disease/stroke
Infant immunizations
Infant death
Knowledge of available health care services
Lack of exercise
Lung, asthma or other respiratory illness
Mental health issues
Not eating healthy
Prescription drug abuse/dependence
Oral, dental health
Overweight/obesity
Teen pregnancy
Tobacco use
Transportation to health care services
Violence

Question Title

* 6. What services are available to you for the following issues?

  No services Some services Enough services Don't know
Access to primary health care
Alcohol/ illegal drug abuse
Arthritis, joint/back pain
Cancer
Diabetes
Heart disease/stroke
Infant immunizations
Infant death
Knowledge of available health care services
Lack of exercise
Lung, asthma or other respiratory illness
Mental health issues
Not eating healthy
Prescription drug abuse/dependence
Oral, dental health
Overweight/obesity
Teen pregnancy
Tobacco use
Transportation to health care services
Violence

Question Title

* 7. What quality of services are available in our community for these issues?

  Quality unacceptable Quality could be improved Good quality Don't know
Access to primary health care
Alcohol/ illegal drug abuse
Arthritis, joint/back pain
Cancer
Diabetes
Heart disease/stroke
Infant immunizations
Infant death
Knowledge of available health care services
Lack of exercise
Lung, asthma or other respiratory illness
Mental health issues
Not eating healthy
Prescription drug abuse/dependence
Oral, dental health
Overweight/obesity
Teen pregnancy
Tobacco use
Transportation to health care services
Violence

Question Title

* 8. In your opinion, are there any other gaps in health care services that need to be improved for our community? (Please be specific)

Question Title

* 9. How would you rate each of the following health services?

  Very poor Poor Fair Good Very good
Ambulance services
Child care
Chiropractors
Dentists
Emergency room
Eye doctor/optometrist
Family planning services
Home health
Hospice
Inpatient services
Mental health
Nursing home
Outpatient services
Pharmacy
Physician clinics
Public health
School nurse
Specialists
0 of 27 answered
 

T