Clara Barton Hospital & Clinics in conjunction with the Barton County Health Department are asking for public input regarding the health needs of our community. These survey results will be compiled and will aid in the development of the Community Health Needs Assessment. Your input will help to identify key focus areas enabling us to better serve the health needs of our community. Please take a moment to fill out our survey and share your thoughts on the health of our community. While your participation is voluntary and confidential, all community input is valued. Surveys will be collected until Friday, February 12th. Thank you for your input!

Question Title

* 1. What is your gender?

Question Title

* 2. What is your age?

Question Title

* 3. What is your race/ethnicity? 

Question Title

* 4. What is your highest level of education?

Question Title

* 5. What is your profession? (e.g., homemaker, student, retired, military)

Question Title

* 6. What is your employment status?

Question Title

* 7. What is your home ZIP code? Please enter 5-digit ZIP code; (for example, 00544 or 94305)

Question Title

* 8. Please select which healthcare facility you use the most.

Question Title

* 9. How would you rate the "Overall Quality" of healthcare delivery in our community?

Question Title

* 10. Is the quality of health in your community..

Question Title

* 11. Are there any healthcare services that you feel need to be
improved, worked on and/or changed? (Please be specific)

Question Title

* 12. How would you rate the Communities perception of the Healthcare Providers serving your population?

Question Title

* 13. In your own words, explain your rating. (Be specific)

Question Title

* 14. The following health needs were identified as priorities in past assessments. Please select the Top Three that continue to be a concern for your community.

Question Title

* 15. Are there any other health needs (listed below) that need to be discussed
further at our upcoming CHNA Town Hall meeting? (Please select all that
apply)

Question Title

* 16. How many days a week do you exercise?

Question Title

* 17. How many days during the past 30 days was your mental health not good?

Question Title

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

  Very Good Good Fair Poor Very Poor N/A
Ambulance Services
Child Care
Chiropractors
Dentists
Emergency Room
Eye Doctor/Optometrist
Home Health
Hospice
Public Transportation
Inpatient Services
Mental Health
Nursing Home
Outpatient Services
Pharmacy
Physician Clinics
Public Health
Specialists

Question Title

* 19. Community Health Readiness is vital. How would you rate each of the
following?

  Very Good Good Fair Poor Very Poor N/A
Caregiver Support Groups
Early Childhood Development Programs
Food and Nutrition Services/Education
Health Screenings
Immunization Programs
Obesity Prevention & Treatment
Spiritual Health Support
Pre/Postnatal Child Health Programs (WIC, VFC SNAP, SHCN)
Sexually Transmitted Disease Testing
Substance Use Treatment and Education
Tobacco Prevention and Cessation Programs
Violence Prevention

Question Title

* 20. In the past 2 years, did you or someone you know receive healthcare services outside of our community?

Question Title

* 21. How would you rate our healthcare organizations, providers and elect officials that are actively working together to address community health?

Question Title

* 22. The COVID-19 Pandemic has affected people in many ways. (select all that apply to you)

Question Title

* 23. Would you be willing to receive the flu shot?

Question Title

* 24. How do you feel about the COVID-19 Vaccination? 

Question Title

* 25. Do you have Health Insurance?

Question Title

* 26. Do you have Dental Insurance?

T