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* 1. Are you familiar with the services the Health Department provides?

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* 2. Have you ever received any services from the Health Department?

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* 3. Does the Health Department provide sufficient services to meet the needs of our community?

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* 4. If not, what additional services should the Health Department provide?

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* 5. The Health Department is open Monday-Friday from 8 AM-5 PM. Are these hours of operation sufficient to meet the needs of the community?

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* 6. If no, please check the hours that would meet your needs. Check all that apply.

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* 7. Does Jackson County have a problem with any of the issues below? (Rate 1-5, 1 meaning low or no problem and 5 meaning high or very much a problem)

  1 2 3 4 5
Healthy food choices
Physical inactivity
Employment
Mental health care
Injuries
Recreation facilities
Violence
Illegal drugs
Care for seniors

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* 8. Which of the following programs would you be interested in participating in? Mark all that apply.

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* 9. Additional comments.

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