Thank you for taking the time to complete this survey. This survey is completely anonymous and voluntary.  The information provided will not be traced back to you. The Health Department and our community partners are looking for information so that we may understand your needs and serve you better. Your feedback is very important to us. If you are not comfortable answering a question, leave it blank. Thank you!

Question Title

* 1. What do you see as your biggest health needs?

Question Title

* 2. Are you able to get care for the needs listed above?

Question Title

* 3. Are you able to get medicine (if needed)?

Question Title

* 4. What stops you from getting the care you need?

Question Title

* 5. Do you have access to transportation to get where you need to go for appointments/work/medical care/other?

Question Title

* 6. Please check all of the boxes that apply to you in the past year:

Question Title

* 7. Please select your age group:

0 of 7 answered
 

T