Copy of Office of Resiliency

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* 1. If the New Jersey Dept. Health or other state agency was able to steer dollars to our area to improve something specific, in your opinion, what would that be?

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* 2. If you would need anything for your health or community, where would you go?

Family Success Center

Board of Social Services

Local house of worship

other

Other (please specify)

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* 3. What are barriers you have come up against in seeking to improve your health or community?

Transportation

Internet Access

Language

Completing Paperwork

Other

Other (please specify)

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* 4. What resources do you have access to? Do you know what is available to you? Services/programs?

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* 5. Do you have goals for improving your health or community?

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* 6. What would help you reach your goal(s)?

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* 7. Demographics

Male

Female

Prefer not to answer

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* 8. Age

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Copy of Office of Resiliency

Question Title

* 1. If the New Jersey Dept. Health or other state agency was able to steer dollars to our area to improve something specific, in your opinion, what would that be?

Question Title

* 2. If you would need anything for your health or community, where would you go?

Question Title

* 3. What are barriers you have come up against in seeking to improve your health or community?

Question Title

* 4. What resources do you have access to? Do you know what is available to you? Services/programs?

Question Title

* 5. Do you have goals for improving your health or community?

Question Title

* 6. What would help you reach your goal(s)?

Question Title

* 7. Demographics

Question Title

* 8. Age

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* 9. Town or Municipality