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* 1. What is your gender?

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* 2. What category below includes your age?

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* 3. Do you have children currently living in your home (at least most of the time) within any of the following age ranges?  (check all that apply)

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* 4. How would you describe your general health?

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* 5. Where do you get most of your health information

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* 6. Would you like to learn more about any of these health issues (check all that apply)?

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* 7. How would you like to be informed on these issues (check all that apply)?

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* 8. Would you like to receive educational information on potential sources of lead within your home, and how to determine if you have elevated levels?

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* 9. How satisfied are you with your own nutrition-information and the nutrition information your children receive from school?

 
Very Satisfied
Satisfied
Dissatisfied
Very Dissatified

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* 10. Would it be useful to have more information regarding opioid overuse?

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* 11. Would you be interested in Narcan training?

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* 12. What can the Mountain Lakes Health Commission do to better serve the community?

T