BACKGROUND

The purpose of this survey is to find out what you think about health and the strengths and needs of your community.  Your answers are very important to us and are anonymous - your name will not appear anywhere on this survey.

This survey is completely voluntary.  Your choice to participate will in no way affect your ability to access services.

The results of this survey will be analyzed and used for development of community health priorities.

This is a wonderful way for you to have a voice in community planning.  Thank you for your participation!

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* 1. How satisfied are you with the quality of life in your community?

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* 2. How proud are you to live, learn, work and play in Kitsap County?

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* 3. Thinking about the amount of stress in your life, how stressful are most days?

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* 4. How socially connected do you feel to your community?  Connected means being socially involved with others in your community.

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* 5. How would you rate your community's health overall?

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* 6. What do you think are the THREE most important things that make a healthy community?
(Please pick 3.)

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* 7. Which of the following do you wish were more present in your community?
(Please pick your top 3.)

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* 8. In your opinion, what THREE things cause the biggest problems to your community's overall health?
(Please pick 3.)

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* 9. In your opinion, what FIVE things most impact the health of families with young children (age 0-10) in your community?
(Please pick 5)

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* 10. In your opinion, what FIVE things most impact the health of youth (age 11-18) in your community?
(Please pick 5.)

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* 11. In your opinion, what FIVE things most impact the health of adults (age 19-64) in your community?
(Please pick 5.)

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* 12. In your opinion, what FIVE things most impact the health of older adults (ages 65+) in your community?
(Please pick 5.)

In this last section we have some questions about you.

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* 13. What is your gender?

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* 14. What is your age?

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* 15. Do you have a child in your household under the age of 18?

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* 16. Do you identify as Hispanic or Latino?

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* 17. Which race or races do you identify as? (Please choose all that apply)

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* 18. What is your highest level of education?

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* 19. In the last year, has your household lost housing or had to move due to any of the following? Check all that apply

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* 20. How long have you lived in Kitsap County?

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* 21. What is your zip code?

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