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Your opinion is important to us.
PLEASE TAKE A FEW MINUTES TO COMPLETE THIS SURVEY. 

* 1. How long have you lived in Jefferson County?

* 2. What is your zip code?

* 3. Of the list below, which SIX issues concern you the most in your neighborhood or community?

* 4. Of the list below, which SIX are most important issues for your family?

* 5. What is your age?

* 6. What is your gender?

* 7. What is your ethnic group?

* 8. What is the highest level of education you achieved? Check one.

* 9. Are you the head of your household?

* 10. Do you own or rent you home?

* 11. What is your employment status? Check one.

* 12. Do you have health insurance? Check one.

* 13. How many adults, counting yourself, live in your household?

* 14. How many children (ages birth-17) live in your household?

* 15. Is anyone in your household disabled? 

* 16. If yes, how old are they?

* 17. What is your annual income?

* 18. We welcome your additional comments...

You're done! Thank you for completing the JCCEO 2017 Client Survey!

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