Skip to content

Klamath County Community Health Assessment Survey

Thank you for participating in this survey created by Healthy Klamath. Information about the health and wellness of residents of Klamath County will be gathered here. Please select the responses below that most closely apply to you.

If you have previously completed this survey, thank you. Please do not complete it again.
1.Where in Klamath County do you live?
2.In general, would you say your health is:
3.Do you have reliable transportation?
4.Do you find public transportation convenient and easy to use?
5.In the past 12 months, have you worried that your food would run out before you got money to buy more?
6.What is your housing situation today?
7.In the past 12 months, have you used any of the following services? Check all that apply.
8.In the past 12 months have any of the following issues kept you from using health care services? Check all that apply.
9.If there was an issue that kept you from using health care services, which of the following were you unable to use? Check all that apply.
10.In the past 30 days have you had a medical, dental, or mental health appointment you missed or skipped?
11.In the past 30 days, how often did mental health concerns (such as depression, anxiety or other mental health issues) make it hard for you to do your usual activities, such as self-care or work?
12.In the past 30 days, how often did pain make it hard for you to do your usual activities, such as self-care or work?
13.If you are a member of Cascade Health Alliance, have you been offered case management?
14.Is there anything you feel is keeping you from having better health? Check all that apply.
15.What is your age?
16.What is the highest level of education you completed?
17.How many people usually live in your household?
18.What is your yearly household income?
19.Do you have health insurance?
20.If you have insurance, what type do you have?
21.What is your employment status?
22.What is your gender identity?
23.How would you describe your sexual orientation?
24.What is your race?
25.Do you identify as Hispanic or Latina/Latino?
26.Select all of the languages spoken in your home:
Current Progress,
0 of 26 answered