Genesee-Orleans-Wyoming (GOW) Community Health Assessment Feedback Form- 2022-2024

The Genesee, Orleans, and Wyoming County Health Departments (GOW) continually gather data on the GOW Community Health Assessment (CHA) and publish the findings every three years. Having your input will help us plan future health assessments.

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* 1. What county do you live in?

Genesee

Orleans

Wyoming

I work in Genesee, Orleans or Wyoming Counties

Other (please specify)

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* 2. What best describes you?

Community Resident

Community-based Organization Employee

Work for Private Employer

Work for Healthcare Organization

Self-employed

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* 3. Do you partner with any of the three (3) Health Departments?

Yes

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* 4. Have you reviewed the 2022-2024 GOW CHA?

Yes

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* 5. If not, why?

Wasn't aware of it

Don't know where to find it

Not of interest

Other (please specify)

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* 6. What data surprised you the most? And why?

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* 7. What data do you feel is missing and wish was included?

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* 8. Other comments or questions regarding the CHA?

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* 9. If you would like to be a part of the GOW Community Health Assessment process, please include your e-mail address and/or phone number below. Over the next three years, we may be in contact with you for your feedback, to seek participation in focus groups, etc.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

For more information about your County's Health Department please visit our websites:

For Genesee and Orleans Counties: https://GOHealthNY.org
For Wyoming County: https://www.wyomingco.net/203/Health-Department

We value your feedback. Thank you for commenting on the GOW CHA.