* 1. Are you familiar with the services the Health Department provides?

* 2. Have you ever received any services from the Health Department?

* 3. Do the following Health Department services meet the needs of our community?

  Yes No No Opinion
Adult Health (Physical/Wellness)
Animal Shelter/Control
Care Coordination for Children
Car Seats
Communicable Disease
Employee Health
Environmental Health Plan Review
Family Planning (Birth Control)
Food/Lodging Inspection
Health Promotion and Education
School Health Assessments
Laboratory Services
Maternity Clinic
Nutrition Services
Obstetric Care Management
Septic System Permits
Sexually Transmitted Diseases Clinic
Sports Physicals
Well/Water Permits
Well/Water Sampling
WIC (Women, Infants, and Children)

* 4. Are there any additional services that the Health Department could offer to better meet the needs of our community?

* 5. The Health Department is open Monday-Friday from 8 AM-5 PM. Are these hours of operation sufficient to meet the needs of our community?

* 6. If no, please check the hours that would meet your needs. Check all that apply.

* 7. The Health Department acknowledges that travel is difficult in Jackson County. The main location of the Health Department is in Sylva, NC with a satellite location in Cashiers, NC. What other communities in our county do you think could benefit from a satellite location?

* 8. Would you be in support of a mobile clinic that could travel to various communities in Jackson County, offering Health Department services?

* 9. Additional comments.