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ENGLISH-2025 Community Needs Assessment

We Need Your Voice!

Kit Carson County Memorial Hospital and the Kit Carson County Public Health and Environment are conducting a Community Health Needs Assessment Survey to better understand the needs of our county. The purpose of the survey is to obtain information from a wide range of members of our community to assist in planning our programs, services, and facilities to meet present and future healthcare needs. By completing this survey, you can help guide us in the development of healthcare services. We appreciate you taking the time to complete this survey, which is estimated to take around 10 minutes. All responses will be kept confidential.
How would you rate the health of our community overall?(Required.)
Select the THREE most serious health concerns in your community.(Required.)
Select the THREE items below that are most important for a healthy community.(Required.)
How would you rate the safety of the community?(Required.)
In the past three years, was there a time when you or a household member thought you needed healthcare services but you delayed or did not receive medical services?(Required.)
If you answered yes to the previous questions, select the THREE most important reasons why you did NOT receive healthcare services.
Are you able to afford prescription medications? (Please select only ONE)(Required.)
If you do NOT have medical insurance, why? (Please select only ONE)(Required.)
How would you rate your OVERALL personal health?(Required.)
Does someone in your household live with a disability?(Required.)
How many days in the last month were you not able to fully complete your activities because of poor PHYSICAL health?(Required.)
How many days in the last month were you not able to fully complete your activities because of poor MENTAL health?(Required.)
What types of healthcare settings have you or a family member used in the past 24 months, in Kit Carson County?(Required.)
What types of healthcare settings have you or a family member used in the past 24 months, OUTSIDE of Kit Carson County?(Required.)
Please list all the cities where you and/or your household members received care in the past 24 months:
Why did you or a family member choose to see a healthcare provider outside of Kit Carson County? (Select all that apply):(Required.)
What type(s) of specialist(s) have you or someone in your household been to within the past 24 months?(Required.)
What is your living situation today?
Think about the place you live. Do you have problems with any of the following?(Required.)
Within the past 12 months, you worried that your food would run out before you got money to buy more.
Within the past 12 months, the food you bought just didn't last and you didn't have money to get more.
In the past 12 months, has lack of reliable transportation kept you from medical appointments, meetings, work or from getting to things needed for daily living?
In the past 12 months has the electric, gas, oil, or water company threatened to shut off services in your home?
How often do you feel lonely or isolated from those around you?
How likely are you to use a digital platform (telehealth, web portals, etc.)?
What additional health services are needed in your community? (Select all that apply)(Required.)
How do you get your health information?(Required.)
What is your age?
Please list your zip code(Required.)
How many months of the year do you live in this residence?(Required.)
What is your gender?
What race do you identify most closely?
What ethnicity do you identify with the most?
Which of the following categories best describes your employment status?
What is the highest level of school you have completed or the highest degree you have received?
Current Progress,
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