The Office of Title V and Family Health at the Texas Department of State Health Services greatly appreciates you taking the time to complete this survey. Your responses will inform the selection of the Title V National Performance Measures for the next five years (fiscal year 2016-2020). Federal guidance allows states to select one Performance Measure in each of the six population domains, plus two additional Performance Measures from any population domain. Please take a moment to tell us about your role in Maternal and Child Health before completing the survey. Thank you for your feedback!

Please select the response that best describes your work setting:

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* 1. Please select the response that best describes your work setting:

Please select the response that best describes your area of focus:

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* 2. Please select the response that best describes your area of focus:

Please enter your work zip code:

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* 3. Please enter your work zip code:

Please rank the following Performance Measures in the Maternal & Women's Health Domain:

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* 4. Please rank the following Performance Measures in the Maternal & Women's Health Domain:

Please rank the following Performance Measures in the Perinatal Health Domain:

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* 5. Please rank the following Performance Measures in the Perinatal Health Domain:

Please rank the following Performance Measures in the Child Health domain:

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* 6. Please rank the following Performance Measures in the Child Health domain:

Please rank the following Performance Measures in the Children with Special Health Care Needs domain:

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* 7. Please rank the following Performance Measures in the Children with Special Health Care Needs domain:

Please rank the following Performance Measures in the Adolescent Health domain:

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* 8. Please rank the following Performance Measures in the Adolescent Health domain:

Please rank the following Performance Measures in the Crosscutting or Life Course domain:

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* 9. Please rank the following Performance Measures in the Crosscutting or Life Course domain:

Other than the highest ranked Performance Measure you selected from each of the 6 domains, please select TWO additional critical measures (Texas will be selecting a total of 8 Performance Measures):

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* 10. Other than the highest ranked Performance Measure you selected from each of the 6 domains, please select TWO additional critical measures (Texas will be selecting a total of 8 Performance Measures):

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