Per requirements, Regional Medical Center and Delaware County Public Health work together to conduct a community-wide health needs assessment. These questions will help identify what you feel our health concerns are within Delaware County.

Survey results will be incorporated into our implementation strategy and community health improvement plan. We also share the results with applicable community resources to help improve the health of our county. Thank you for your participation!

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* 1. Which 5 topics do you consider the top concerns in Delaware County? (choose only 5)

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* 2. (OPTIONAL) If you noted "illegal drug use" as a concern above, note which drug(s)

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* 3. (OPTIONAL) If you noted "Access to healthcare (e.g. family provider)" as a concern above, please expand on this.

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* 4. My zip code is

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* 5. My gender is

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* 6. My age is

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* 7. Ethnic group you most identify with

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* 8. Household income

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* 9. Education

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* 10. How do you pay for your healthcare

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* 11. Other feedback or comments

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