* 1. I am a resident of which neighborhood?

* 2. What is your age?

* 3. Rank your opinion of the following health concerns from "Not an Issue" to Always an Issue":

  Not an Issue Rarely an Issue Sometimes an Issue Often an Issue Always an Issue
Being physically active
Eating healthy foods
Seeing a doctor
Having a good job
Breathing clean air
Drinking clean water

* 4. Rank your current ability to access the following types of stores and public services from "Not Accessible" to "Easily Accessible"

  Not Accessible Rarely Accessible Sometimes Accessible Easily Accessible Not Applicable to Me
Fresh and healthy food
Healthy and affordable restaurants
Senior citizen centers
Parks and trails
Medical care facilities
Good jobs or job training centers
Community centers

* 5. Rank how you perceive the following health concerns as issues for residents of Gary-New Duluth from "Not an Issue" to "Always an Issue":

  Not an Issue Rarely and Issue Sometimes an Issue Often an Issue Always an Issue
Affordability of housing
Overweight or diabetes
Depression or anxiety
Problems associated with alcohol
Problems associated with drugs and other substances
Asthma or respiratory conditions
Safety from an accident involving a car
Safety from crime

* 6. Rank the key/priority issues you think should be addressed in Gary-New Duluth from "Not a Priority" to High Priority":

  Not a Priority Low Priority Medium Priority High Priority
Affordable housing
Jobs and economic development
Access to public transportation
Parks, trails, open space and recreation
Pedestrian safety and inviting walking environment
Development that has miminal impact on the environment
Air quality
Water quality
Access to goods and services
Farmers markets and community gardens
Crime prevention

* 7. What is your favorite thing about Gary-New Duluth?

* 8. What would you most like to see changed in Gary-New Duluth?

* 9. Is there anything else you would like to share about the Gary-New Duluth neighborhood?

* 10. Would you like to be contacted with opportunities in the Gary-New Duluth Small Area Plan and /or Health Impact Assessment?